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Evaluation of Anti-biofilm Effects of Ferumoxytol (Feraheme) Using an in Situ Biofilm Demineralization Model

Primary Purpose

Dental Caries

Status
Completed
Phase
Early Phase 1
Locations
United States
Study Type
Interventional
Intervention
Ferumoxytol/Hydrogen peroxide
Hydrogen Peroxide
Water
Sponsored by
University of Pennsylvania
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Dental Caries

Eligibility Criteria

18 Years - 85 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Males and females 18 to 85 years of age and in good general and oral health without any known allergies to commercial dental products;
  2. Evidence of a personally signed and dated informed consent document indicating the subject has been informed of all pertinent aspects of the trial;
  3. Willingness to use the assigned products according to instructions, availability for appointments and likelihood of completing the clinical trial;
  4. Willing to adhere to the study requirements and restrictions;
  5. Lower partial denture wearers who have a lower partial denture made for them as a part of a partial denture panel under study 14-I-098 (IRB # 1407637739) or who agree to wear their own pre-approved lower partial denture that can house both specimens on one side of their partial denture.

Exclusion Criteria:

Oral Examination Inclusion Criteria:

  1. Normal salivary flow rate (stimulated and unstimulated flow of ≥ 0.8 mL/min and ≥ 0.2 mL/min, respectively) ascertained from the Screening visit;
  2. Willing and capable of wearing the lower partial denture 24 hours a day for the three, two-week treatment periods. Note: for persons who would otherwise qualify but whose lower partial denture needs repair, the individual may be listed as "pending". Once the partial denture has been repaired and adjusted to fit adequately for the subject to wear the lower partial denture 24 hours a day, the subject may be considered "qualified", complete their minimum 4 to 5 days washout period (of their own fluoridated toothpaste use) and continue with visit 2 in the study;
  3. Absence of significant oral soft tissue pathology and dental caries, based on the dentist's visual examination and at the discretion of the investigator. Note: for persons who would otherwise qualify but who present at screening with dental caries requiring treatment, the individual may be listed as "pending". If the subject completes the restorative work within an acceptable amount of time, the subject may be considered qualified, complete their minimum 4 to 5 day washout period (of their own fluoridated toothpaste use) and continue with visit 2 in the study; and
  4. Adequate oral hygiene (i.e. brush teeth daily and exhibit no signs of oral neglect).

Exclusion Criteria: Subjects presenting with any of the following will not be included in the trial:

  1. Are taking or have ever taken bisphosphonate drugs (i.e., Fosamax, Actonel and Boniva) for the treatment of osteoporosis;
  2. Use of blood thinning medications that prohibit the safe conduct of a dental cleaning (*NOTE: Subjects who are taking blood thinners in which written verification is obtained from their physician indicating their PT/INR levels (anti-coagulation blood levels) are at an acceptable level to avoid serious complications, such as bleeding during dental cleanings, may be accepted into the study);
  3. Suspected alcohol or substance abuse (e.g., amphetamines, benzodiazepines, cocaine, marijuana, opiates) in the past year;
  4. Report allergy to products (Ferumoxytol or other drugs or specific ingredients) used in the study, a reported history of multiple drug allergies or known hypersensitivity to any iron products;
  5. Scheduled for MRI for the head region within three months after study participation involving Ferumoxytol application;
  6. Have a history of significant adverse effects following the use of oral hygiene products such as dentifrices and mouth rinses;
  7. Use of antimicrobial agents/antibiotics whether prescribed or over-the-counter within two weeks prior to each treatment visit;
  8. Presence of severe marginal gingivitis or moderate/advanced periodontitis based on the clinical examination and discretion of the dental examiner;
  9. Subjects who during the study will receive dental treatment, which may affect their participation (i.e. oral prophylaxis). Emergency treatment will be allowed if necessary;
  10. Those requiring antibiotic premedication prior to dental treatment;
  11. Participation in a dental clinical trial involving oral care products within 30 days of randomization (Baseline Visit);
  12. Self-reported pregnancy or lactation or intent to become pregnant during the study period;
  13. Self-reported chewing tobacco user;
  14. Subjects who were previously screened and ineligible or were randomized to receive investigational product;
  15. Significant unstable or uncontrolled medical condition, which may interfere with a subject's participation in the study;
  16. Subjects who are related to those persons involved directly or indirectly with the conduct of this study; and
  17. Other severe, acute or chronic, medical or psychiatric condition(s) or laboratory abnormality that may increase the risk associated with study participation or investigational product administration or may interfere with the interpretation of study results and, in the judgment of the investigator, would make the subject inappropriate for entry into this study.

If the subject reports taking medication, a history of allergy, and/or a chronic disease which in the opinion of the investigator will not affect the clinical parameter(s) being assessed in this study or the safety of the subject, the subject may be enrolled in the study and it will be noted on the Investigator's source document.

Sites / Locations

  • Oral Health Research Institute
  • University of Pennsylvania, School of dental medicine

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Active Comparator

Placebo Comparator

Sham Comparator

Arm Label

Ferumoxytol/Hydrogen peroxide

Hydrogen peroxide

Water

Arm Description

1.5% Ferumoxytol / 3% Hydrogen Peroxide (H2O2) 1:1 ratio

Sham Solution / 3% Hydrogen Peroxide (H2O2) 1:1 ratio

Sham solution (water; negative control)

Outcomes

Primary Outcome Measures

Biofilm Analyses-cell viability
The effect of the treatments will be analyzed in terms of biochemical and microbiological composition of the biofilm formed. Colony forming unit (CFU) will be used to quantify the number of viable cells in biofilms.
Biofilm Analysis-extracellular polysaccharides
Biofilm EPS amount (weight in milligram) will be determined using colorimetric assay.

Secondary Outcome Measures

Assessment of Enamel Demineralization by Means of Surface Microhardness Test (SMH)
The surface microhardness (SMH, length in micrometer) test will be used to assess changes in the mineral status of enamel specimens.

Full Information

First Posted
September 7, 2018
Last Updated
September 17, 2018
Sponsor
University of Pennsylvania
Collaborators
Indiana University
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1. Study Identification

Unique Protocol Identification Number
NCT03678012
Brief Title
Evaluation of Anti-biofilm Effects of Ferumoxytol (Feraheme) Using an in Situ Biofilm Demineralization Model
Official Title
Evaluation of Anti-biofilm Effects of Ferumoxytol (Feraheme) Using an in Situ Biofilm Demineralization Model
Study Type
Interventional

2. Study Status

Record Verification Date
September 2018
Overall Recruitment Status
Completed
Study Start Date
June 7, 2018 (Actual)
Primary Completion Date
August 16, 2018 (Actual)
Study Completion Date
August 16, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Pennsylvania
Collaborators
Indiana University

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
To evaluate the effects of a clinically approved and commercially available iron oxide formulation Ferumoxytol (Feraheme®) to control cariogenic biofilms and enamel demineralization. This study will be testing topical application of Ferumoxytol extra-orally using a standard in situ biofilm demineralization model.
Detailed Description
This will be a randomized, crossover, single blind in situ study with three test periods utilizing 16 subjects. The subjects in this study are lower partial denture wearers who have already had a study partial denture made for them as a part of a partial denture panel under 14-I-098 (IRB # 1407637739) or who will wear their own lower partial denture which was previously approved as part of the panel. The study partial dentures or personal partial dentures can house the specimen holders in two hollowed out areas of the buccal surface of two posterior denture teeth. The subjects will wear the lower partial dentures with enamel specimens in place for three consecutive 14-day study periods.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Dental Caries

7. Study Design

Primary Purpose
Prevention
Study Phase
Early Phase 1
Interventional Study Model
Crossover Assignment
Model Description
This will be a randomized, crossover, single blind in situ study with three test periods utilizing 16 subjects. The subjects in this study are lower partial denture wearers who have already had a study partial denture made for them as a part of a partial denture panel under 14-I-098 (IRB # 1407637739) or who will wear their own lower partial denture which was previously approved as part of the panel. The study partial dentures or personal partial dentures can house the specimen holders in two hollowed out areas of the buccal surface of two posterior denture teeth. The subjects will wear the lower partial dentures with enamel specimens in place for three consecutive 14-day study periods.
Masking
Care ProviderInvestigatorOutcomes Assessor
Masking Description
The study dentist, specimen/sample analysis technicians and the statistician will be blinded to the product allocation of subjects.
Allocation
Randomized
Enrollment
16 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Ferumoxytol/Hydrogen peroxide
Arm Type
Active Comparator
Arm Description
1.5% Ferumoxytol / 3% Hydrogen Peroxide (H2O2) 1:1 ratio
Arm Title
Hydrogen peroxide
Arm Type
Placebo Comparator
Arm Description
Sham Solution / 3% Hydrogen Peroxide (H2O2) 1:1 ratio
Arm Title
Water
Arm Type
Sham Comparator
Arm Description
Sham solution (water; negative control)
Intervention Type
Drug
Intervention Name(s)
Ferumoxytol/Hydrogen peroxide
Other Intervention Name(s)
Feraheme
Intervention Description
1.5% Ferumoxytol / 3% Hydrogen Peroxide (H2O2) 1:1 ratio. Each subject will use this product during one of three treatment periods in the crossover study design.
Intervention Type
Drug
Intervention Name(s)
Hydrogen Peroxide
Intervention Description
Sham Solution / 3% Hydrogen Peroxide (H2O2) 1:1 ratio. Each subject will use this product during one of three treatment periods in the crossover study design.
Intervention Type
Drug
Intervention Name(s)
Water
Intervention Description
Sham solution (water; negative control). Each subject will use this product during one of three treatment periods in the crossover study design.
Primary Outcome Measure Information:
Title
Biofilm Analyses-cell viability
Description
The effect of the treatments will be analyzed in terms of biochemical and microbiological composition of the biofilm formed. Colony forming unit (CFU) will be used to quantify the number of viable cells in biofilms.
Time Frame
14 days
Title
Biofilm Analysis-extracellular polysaccharides
Description
Biofilm EPS amount (weight in milligram) will be determined using colorimetric assay.
Time Frame
14 days
Secondary Outcome Measure Information:
Title
Assessment of Enamel Demineralization by Means of Surface Microhardness Test (SMH)
Description
The surface microhardness (SMH, length in micrometer) test will be used to assess changes in the mineral status of enamel specimens.
Time Frame
14 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
85 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Males and females 18 to 85 years of age and in good general and oral health without any known allergies to commercial dental products; Evidence of a personally signed and dated informed consent document indicating the subject has been informed of all pertinent aspects of the trial; Willingness to use the assigned products according to instructions, availability for appointments and likelihood of completing the clinical trial; Willing to adhere to the study requirements and restrictions; Lower partial denture wearers who have a lower partial denture made for them as a part of a partial denture panel under study 14-I-098 (IRB # 1407637739) or who agree to wear their own pre-approved lower partial denture that can house both specimens on one side of their partial denture. Exclusion Criteria: Oral Examination Inclusion Criteria: Normal salivary flow rate (stimulated and unstimulated flow of ≥ 0.8 mL/min and ≥ 0.2 mL/min, respectively) ascertained from the Screening visit; Willing and capable of wearing the lower partial denture 24 hours a day for the three, two-week treatment periods. Note: for persons who would otherwise qualify but whose lower partial denture needs repair, the individual may be listed as "pending". Once the partial denture has been repaired and adjusted to fit adequately for the subject to wear the lower partial denture 24 hours a day, the subject may be considered "qualified", complete their minimum 4 to 5 days washout period (of their own fluoridated toothpaste use) and continue with visit 2 in the study; Absence of significant oral soft tissue pathology and dental caries, based on the dentist's visual examination and at the discretion of the investigator. Note: for persons who would otherwise qualify but who present at screening with dental caries requiring treatment, the individual may be listed as "pending". If the subject completes the restorative work within an acceptable amount of time, the subject may be considered qualified, complete their minimum 4 to 5 day washout period (of their own fluoridated toothpaste use) and continue with visit 2 in the study; and Adequate oral hygiene (i.e. brush teeth daily and exhibit no signs of oral neglect). Exclusion Criteria: Subjects presenting with any of the following will not be included in the trial: Are taking or have ever taken bisphosphonate drugs (i.e., Fosamax, Actonel and Boniva) for the treatment of osteoporosis; Use of blood thinning medications that prohibit the safe conduct of a dental cleaning (*NOTE: Subjects who are taking blood thinners in which written verification is obtained from their physician indicating their PT/INR levels (anti-coagulation blood levels) are at an acceptable level to avoid serious complications, such as bleeding during dental cleanings, may be accepted into the study); Suspected alcohol or substance abuse (e.g., amphetamines, benzodiazepines, cocaine, marijuana, opiates) in the past year; Report allergy to products (Ferumoxytol or other drugs or specific ingredients) used in the study, a reported history of multiple drug allergies or known hypersensitivity to any iron products; Scheduled for MRI for the head region within three months after study participation involving Ferumoxytol application; Have a history of significant adverse effects following the use of oral hygiene products such as dentifrices and mouth rinses; Use of antimicrobial agents/antibiotics whether prescribed or over-the-counter within two weeks prior to each treatment visit; Presence of severe marginal gingivitis or moderate/advanced periodontitis based on the clinical examination and discretion of the dental examiner; Subjects who during the study will receive dental treatment, which may affect their participation (i.e. oral prophylaxis). Emergency treatment will be allowed if necessary; Those requiring antibiotic premedication prior to dental treatment; Participation in a dental clinical trial involving oral care products within 30 days of randomization (Baseline Visit); Self-reported pregnancy or lactation or intent to become pregnant during the study period; Self-reported chewing tobacco user; Subjects who were previously screened and ineligible or were randomized to receive investigational product; Significant unstable or uncontrolled medical condition, which may interfere with a subject's participation in the study; Subjects who are related to those persons involved directly or indirectly with the conduct of this study; and Other severe, acute or chronic, medical or psychiatric condition(s) or laboratory abnormality that may increase the risk associated with study participation or investigational product administration or may interfere with the interpretation of study results and, in the judgment of the investigator, would make the subject inappropriate for entry into this study. If the subject reports taking medication, a history of allergy, and/or a chronic disease which in the opinion of the investigator will not affect the clinical parameter(s) being assessed in this study or the safety of the subject, the subject may be enrolled in the study and it will be noted on the Investigator's source document.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Hyun Koo, Ph.D
Organizational Affiliation
University of Pennsylvania
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Domenick Zero, Ph.D
Organizational Affiliation
Indiana University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Oral Health Research Institute
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46202
Country
United States
Facility Name
University of Pennsylvania, School of dental medicine
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
IPD Sharing Plan Description
No plan to share
Citations:
PubMed Identifier
29102240
Citation
Cormode DP, Gao L, Koo H. Emerging Biomedical Applications of Enzyme-Like Catalytic Nanomaterials. Trends Biotechnol. 2018 Jan;36(1):15-29. doi: 10.1016/j.tibtech.2017.09.006. Epub 2017 Oct 26.
Results Reference
background
PubMed Identifier
27294544
Citation
Gao L, Liu Y, Kim D, Li Y, Hwang G, Naha PC, Cormode DP, Koo H. Nanocatalysts promote Streptococcus mutans biofilm matrix degradation and enhance bacterial killing to suppress dental caries in vivo. Biomaterials. 2016 Sep;101:272-84. doi: 10.1016/j.biomaterials.2016.05.051. Epub 2016 Jun 2.
Results Reference
background

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Evaluation of Anti-biofilm Effects of Ferumoxytol (Feraheme) Using an in Situ Biofilm Demineralization Model

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