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An Evaluation of the Safety of Intravenous Tc 99m Tilmanocept and a Comparison of Imaging With Sulfur Colloid in Subjects With and Without NASH

Primary Purpose

Nonalcoholic Steatohepatitis, NASH - Nonalcoholic Steatohepatitis

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Tc 99M Sulfur Colloid
Tc99m-tilmanocept
Sponsored by
Navidea Biopharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional diagnostic trial for Nonalcoholic Steatohepatitis focused on measuring Tc99m-tilmanocept, Tilmanocept, NASH, Nonalcoholic Steatohepatitis

Eligibility Criteria

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

Inclusion Criteria:

  • ALL SUBJECTS:

    1. The subject has provided written informed consent with HIPAA (Health Information Portability and Accountability Act) authorization before the initiation of any study-related procedures.
    2. The subject is ≥18 years of age at the time of consent.
    3. The subject has a body mass index (BMI) between 18 and 45.

      CONTROL SUBJECTS:

    4. The subject is deemed to be clinically free of any infectious/inflammatory disease(s) for at least 4 weeks prior to the consent date.
    5. The subject has not taken any antibiotics for at least 4 weeks prior to the consent date.

NASH SUBJECTS:

4. The subject has biopsy-confirmed NASH within 12 months prior to enrollment. 5. The subject has a NAFLD Activity Score (NAS) of ≥ 4, with a score of at least 1 for each steatosis, lobular inflammation, and hepatocyte ballooning.

6. The subject has fibrosis staging of F3-F4.

Exclusion Criteria:

  • ALL SUBJECTS:

    1. The subject is pregnant or lactating.
    2. The subject size or weight is not compatible with imaging per the investigator.
    3. The subject has received radiation therapy or chemotherapy or has a previous diagnosis of cancer other than basal cell carcinoma.
    4. The subject has renal insufficiency as demonstrated by a GFR of < 60 mL/min.
    5. The subject has a chronic or persistent infection or has any condition that would, in the opinion of the examining physician, preclude their participation.
    6. The subject has a known allergy to or has had an adverse reaction to dextran exposure.
    7. The subject has received an investigational product within 30 days prior to the Tc 99m sulfur colloid administration.
    8. The subject has received any radiopharmaceutical within 7 days prior to the administration of Tc 99m sulfur colloid.
    9. The subject is HIV positive.
    10. The subject has a history of alcohol abuse or currently consumes alcohol in excess of 3 drinks/day for men or 2 drinks/day for women.
    11. The subject has hepatitis B or C.

      CONTROL SUBJECTS:

    12. The subject has hepatic insufficiency as demonstrated by ALT (alanine aminotransferase [SGPT]) or AST (aspartate aminotransferase [SGOT]) greater than two times the upper limit of normal (ULN).
    13. The subject has been diagnosed with NASH, NAFLD, or other chronic liver disease.
    14. The subject has been diagnosed with metabolic syndrome or Type I or II diabetes.

NASH SUBJECTS:

12. The subject has any chronic liver disease aside from NASH/NAFLD.

13. The subject has uncontrolled diabetes as indicated by an A1c >9% within the 3 months prior to enrollment.

Sites / Locations

  • Kettering Medical Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Tc99m-sulfur colloid + Tc99m-tilmanocept

Arm Description

All subjects will receive a single IV injection of unfiltered sulfur colloid radiolabeled with 8 mCi Tc99m on study day 0. All subjects will receive a single IV injection of 200 mcg tilmanocept radiolabeled with 8 mCi Tc99m on study day 3.

Outcomes

Primary Outcome Measures

Adverse Drug Reaction
Proportion of subjects experiencing noxious pharmacologic activity/an Adverse Drug Reaction (ADR).

Secondary Outcome Measures

Localization of Tc 99m tilmanocept
Determine the three dimensional tessellation localization of Tc 99m tilmanocept by planar and SPECT/CT imaging in subjects with NASH and asymptomatic controls.
Localization of Tc 99m sulfur colloid
Determine the three dimensional tessellation localization of unfiltered Tc 99m sulfur colloid by planar and SPECT/CT imaging in subjects with NASH and asymptomatic controls.
Localization Distribution Comparison
Comparison of liver localization distribution tessellation pattern intensities between Tc 99m tilmanocept and unfiltered Tc 99m sulfur colloid.

Full Information

First Posted
November 1, 2017
Last Updated
March 19, 2019
Sponsor
Navidea Biopharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT03332940
Brief Title
An Evaluation of the Safety of Intravenous Tc 99m Tilmanocept and a Comparison of Imaging With Sulfur Colloid in Subjects With and Without NASH
Official Title
An Evaluation of the Safety of Intravenous (IV) Tc 99m Tilmanocept and a Comparison of Localization to Tc 99m Sulfur Colloid in Subjects With Nonalcoholic Steatohepatitis (NASH) and Healthy Controls (HC)
Study Type
Interventional

2. Study Status

Record Verification Date
March 2019
Overall Recruitment Status
Completed
Study Start Date
December 6, 2017 (Actual)
Primary Completion Date
March 10, 2019 (Actual)
Study Completion Date
March 10, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Navidea Biopharmaceuticals

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
This is a prospective, open-label, multicenter, safety, comparative study of IV administered Tc99m-tilmanocept and unfiltered Tc99m sulfur colloid in the detection of and assessment of three dimensional tessellation localization to the liver in subjects with and without moderate to severe nonalcoholic steatohepatitis (NASH) by planar and SPECT/CT imaging. This study is designed to evaluate the safety and tolerability of Tc99m-tilmanocept in subjects with NASH.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Nonalcoholic Steatohepatitis, NASH - Nonalcoholic Steatohepatitis
Keywords
Tc99m-tilmanocept, Tilmanocept, NASH, Nonalcoholic Steatohepatitis

7. Study Design

Primary Purpose
Diagnostic
Study Phase
Phase 1
Interventional Study Model
Sequential Assignment
Masking
None (Open Label)
Enrollment
6 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Tc99m-sulfur colloid + Tc99m-tilmanocept
Arm Type
Experimental
Arm Description
All subjects will receive a single IV injection of unfiltered sulfur colloid radiolabeled with 8 mCi Tc99m on study day 0. All subjects will receive a single IV injection of 200 mcg tilmanocept radiolabeled with 8 mCi Tc99m on study day 3.
Intervention Type
Drug
Intervention Name(s)
Tc 99M Sulfur Colloid
Other Intervention Name(s)
Sulfur colloid
Intervention Description
Sulfur colloid is a radiotracer that is indicated for imaging areas of functional reticuloendothelial cells in the liver, spleen, and bone marrow.
Intervention Type
Drug
Intervention Name(s)
Tc99m-tilmanocept
Other Intervention Name(s)
Tilmanocept, Lymphoseek
Intervention Description
Tilmanocept is a radiotracer that accumulates in macrophages by binding to a mannose binding receptor that resides on the surface.
Primary Outcome Measure Information:
Title
Adverse Drug Reaction
Description
Proportion of subjects experiencing noxious pharmacologic activity/an Adverse Drug Reaction (ADR).
Time Frame
5 days after Tc 99m tilmanocept injection
Secondary Outcome Measure Information:
Title
Localization of Tc 99m tilmanocept
Description
Determine the three dimensional tessellation localization of Tc 99m tilmanocept by planar and SPECT/CT imaging in subjects with NASH and asymptomatic controls.
Time Frame
5 days after Tc 99m tilmanocept injection
Title
Localization of Tc 99m sulfur colloid
Description
Determine the three dimensional tessellation localization of unfiltered Tc 99m sulfur colloid by planar and SPECT/CT imaging in subjects with NASH and asymptomatic controls.
Time Frame
5 days after Tc 99m tilmanocept injection
Title
Localization Distribution Comparison
Description
Comparison of liver localization distribution tessellation pattern intensities between Tc 99m tilmanocept and unfiltered Tc 99m sulfur colloid.
Time Frame
5 days after Tc 99m tilmanocept injection
Other Pre-specified Outcome Measures:
Title
Tc 99m tilmanocept Localization Distribution of SPECT/CT vs Elastography
Description
Concordance of intrahepatic localization tessellation discrimination of Tc 99m tilmanocept (intrahepatic disease heterogeneity) by SPECT/CT imaging and elastography.
Time Frame
5 days after Tc 99m tilmanocept injection
Title
Tc 99m sulfur colloid Localization Distribution of SPECT/CT vs Elastography
Description
Concordance of intrahepatic localization tessellation discrimination of Tc 99m sulfur colloid (intrahepatic disease heterogeneity) by SPECT/CT imaging and elastography.
Time Frame
5 days after Tc 99m tilmanocept injection

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: ALL SUBJECTS: The subject has provided written informed consent with HIPAA (Health Information Portability and Accountability Act) authorization before the initiation of any study-related procedures. The subject is ≥18 years of age at the time of consent. The subject has a body mass index (BMI) between 18 and 45. CONTROL SUBJECTS: The subject is deemed to be clinically free of any infectious/inflammatory disease(s) for at least 4 weeks prior to the consent date. The subject has not taken any antibiotics for at least 4 weeks prior to the consent date. NASH SUBJECTS: 4. The subject has biopsy-confirmed NASH within 12 months prior to enrollment. 5. The subject has a NAFLD Activity Score (NAS) of ≥ 4, with a score of at least 1 for each steatosis, lobular inflammation, and hepatocyte ballooning. 6. The subject has fibrosis staging of F3-F4. Exclusion Criteria: ALL SUBJECTS: The subject is pregnant or lactating. The subject size or weight is not compatible with imaging per the investigator. The subject has received radiation therapy or chemotherapy or has a previous diagnosis of cancer other than basal cell carcinoma. The subject has renal insufficiency as demonstrated by a GFR of < 60 mL/min. The subject has a chronic or persistent infection or has any condition that would, in the opinion of the examining physician, preclude their participation. The subject has a known allergy to or has had an adverse reaction to dextran exposure. The subject has received an investigational product within 30 days prior to the Tc 99m sulfur colloid administration. The subject has received any radiopharmaceutical within 7 days prior to the administration of Tc 99m sulfur colloid. The subject is HIV positive. The subject has a history of alcohol abuse or currently consumes alcohol in excess of 3 drinks/day for men or 2 drinks/day for women. The subject has hepatitis B or C. CONTROL SUBJECTS: The subject has hepatic insufficiency as demonstrated by ALT (alanine aminotransferase [SGPT]) or AST (aspartate aminotransferase [SGOT]) greater than two times the upper limit of normal (ULN). The subject has been diagnosed with NASH, NAFLD, or other chronic liver disease. The subject has been diagnosed with metabolic syndrome or Type I or II diabetes. NASH SUBJECTS: 12. The subject has any chronic liver disease aside from NASH/NAFLD. 13. The subject has uncontrolled diabetes as indicated by an A1c >9% within the 3 months prior to enrollment.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Michael Blue, MD
Organizational Affiliation
Navidea Biopharmaceuticals, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
Kettering Medical Center
City
Kettering
State/Province
Ohio
ZIP/Postal Code
45429
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
27866590
Citation
Cope FO, Abbruzzese B, Sanders J, Metz W, Sturms K, Ralph D, Blue M, Zhang J, Bracci P, Bshara W, Behr S, Maurer T, Williams K, Walker J, Beverly A, Blay B, Damughatla A, Larsen M, Mountain C, Neylon E, Parcel K, Raghuraman K, Ricks K, Rose L, Sivakumar A, Streck N, Wang B, Wasco C, Williams A, Schlesinger LS, Azad A, Rajaram MVS, Jarjour W, Young N, Rosol T, McGrath M. Corrigendum to the inextricable axis of targeted diagnostic imaging and therapy: An immunological natural history approach [Nucl Med Biol 43 (2016) 215-225]. Nucl Med Biol. 2016 Dec;43(12):837. doi: 10.1016/j.nucmedbio.2016.10.001. No abstract available.
Results Reference
background
Citation
Cope, F.O., W. Metz, et al. Innovations in receptor-targeted precision imaging at Navidea: diagnosis up close and personal. Nature Outlook (31 October 2013); S125-S129.
Results Reference
background
Links:
URL
https://www.navidea.com/
Description
Navidea Biopharmaceuticals, Inc.

Learn more about this trial

An Evaluation of the Safety of Intravenous Tc 99m Tilmanocept and a Comparison of Imaging With Sulfur Colloid in Subjects With and Without NASH

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