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Safety and Efficacy of EcoActive on Intestinal Adherent Invasive E. Coli in Patients With Inactive Crohn's Disease

Primary Purpose

Crohn Disease

Status
Recruiting
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Placebo
Bacteriophage preparation
Sponsored by
Intralytix, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Crohn Disease focused on measuring Phage, Bacteriophage, AIEC

Eligibility Criteria

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

Inclusion Criteria:

  1. Male or female ≥ 18 years of age
  2. Inactive Crohn's disease in clinical and objective remission with a Harvey-Bradshaw Index (HBI) < 4
  3. Permitted CD medications expected to remain stable during the period of the study (see Section 7 "Concomitant Crohn's Disease Medications" for allowed and prohibited drugs).
  4. Crohn's disease history ≥ 6-month duration
  5. CRP (C-reactive protein) within normal range at the Screening visit (based on normal range of the local laboratory)
  6. Fecal calprotectin level ≤ 150 µg/g at the Screening visit
  7. AIEC detected in the stool
  8. Females of childbearing age must be using an effective method of contraception to prevent pregnancy and agree to continue to practice an acceptable method of contraception for the duration of participation in the study (contraceptive measures considered adequate are: intrauterine devices, hormonal contraceptives, such as contraceptive pills, implants, transdermal patches, hormonal vaginal devices or injections with prolonged release).
  9. Negative pregnancy test for women of childbearing age (menarche to menopause)
  10. Patient understands the study procedures, and can sign the informed consent, and the authorization to release relevant protected health information to the Study Investigator.

Exclusion Criteria:

  1. Active Crohn's disease with a Harvey-Bradshaw Index (HBI) ≥ 4
  2. Ongoing gastrointestinal pathology: colorectal tumor, gastrointestinal bleeding
  3. Active malignancies or any malignant disease within the past 5 years
  4. Indeterminate colitis, ulcerative colitis
  5. Colectomy or partial colectomy (less than ileo-transverse colonic anastomosis).
  6. Colonic or small bowel stoma
  7. Active perianal lesions
  8. Women who are pregnant or nursing, or plan to become pregnant during the study period
  9. Severe uncontrolled diseases that could increase the risk for subjects participating in the study, including but not limited to: heart diseases, congestive heart failure, hypertension, lung diseases; endocrine diseases; clinically significant renal disease characterized by a glomerular filtration rate < 60mL/min, hepatic diseases, haematological disorders, or other conditions that in the opinion of the Investigator could interfere with the interpretation of the study results.
  10. Taking supplemental probiotics in the form of pills or tablets.
  11. History or planned procedures specifically aimed at modifying the gastrointestinal microbiota within the past year.
  12. Topical gastrointestinal treatment (e.g., enemas) in the 2 weeks prior to the Screening visit or planned during the study period
  13. Use of bowel cleansing or preparation for endoscopy, TDM or MRI in the 4 weeks prior to the Screening visit or planned during the study period.
  14. Receipt of antibiotics 4 weeks before the Screening visit or planned during the study period.
  15. Known allergy or hypersensitivity to an excipient in the study drug or placebo
  16. Psychological or linguistic incapability to sign the informed consent.
  17. Lack or expected lack of cooperation or compliance with the study.
  18. Receipt of mesalamine based therapies within 4 weeks of the screening visit.
  19. Severe psychiatric, psychological, or neurological disorders.
  20. Alcohol, drug or medication abuse within the past year.
  21. Subject who cannot be contacted in case of emergency.

Sites / Locations

  • The Mount Sinai HospitalRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Placebo Comparator

Experimental

Arm Label

Placebo

Phage

Arm Description

Dose is 1mL of placebo given orally twice a day for 15 days

Dose is 1mL of bacteriophage preparation given orally twice a day for 15 days

Outcomes

Primary Outcome Measures

Incidence of adverse events
The number of solicited and unsolicited adverse events will be recorded.
Severity of adverse events
The severity will be graded according to the definitions and values stated in CTCAE V04 v4.
Effect on Harvey Bradshaw Index (HBI)
The effect on Crohn's disease activity will be evaluated using the HBI.
Effect on inflammation, as indicated by C-reactive protein (CRP)
The changes in CRP from baseline will be evaluated.
Effect on inflammation, as indicated by fecal calprotectin
The changes in fecal calprotectin levels from baseline will be evaluated.

Secondary Outcome Measures

Effect on the incidence and levels of AIEC
The secondary objective is to assess the effect of oral phage administration on the AIEC (CFU/g) in stools of patients receiving phages vs. patients receiving placebo.

Full Information

First Posted
January 4, 2019
Last Updated
September 26, 2023
Sponsor
Intralytix, Inc.
Collaborators
MOUNT SINAI HOSPITAL
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1. Study Identification

Unique Protocol Identification Number
NCT03808103
Brief Title
Safety and Efficacy of EcoActive on Intestinal Adherent Invasive E. Coli in Patients With Inactive Crohn's Disease
Official Title
A Phase 1/2a Double-Blind, Randomized, Placebo-Controlled Trial to Assess the Safety and Efficacy of Oral Administration of EcoActive on Intestinal Adherent Invasive Escherichia Coli (AIEC) in Patients With Inactive Crohn's Disease (CD)
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Recruiting
Study Start Date
May 1, 2019 (Actual)
Primary Completion Date
September 30, 2024 (Anticipated)
Study Completion Date
September 30, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Intralytix, Inc.
Collaborators
MOUNT SINAI HOSPITAL

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 study will evaluate the safety of oral administration of EcoActive to patients with inactive Crohn's disease and how it affects the levels of AIEC in stool.
Detailed Description
The purpose of this study is to determine if EcoActive is safe and effective in people with Crohn's disease. EcoActive is a collection of bacteriophages. Bacteriophages (or phages) are viruses that infect only bacteria. The phages in EcoActive infect a specific type of bacteria called Adherent Invasive Escherichia coli (AIEC). The cause of Crohn's disease is poorly understood. However, the presence of AIEC in the intestines is associated with worsening inflammation in this disease. Inflammation is the presence of redness, irritation, and ulcers in the intestines. By using phages that only infect and kill this specific type of bacteria (AIEC), it is the hope this can be used to improve the course of Crohn's disease. The phages would only target the AIEC, without affecting the natural, often helpful, bacteria of the intestines. EcoActive may also lessen the use of antibiotics to control symptoms. When antibiotics are used, they can have major effects on the rest of the bacteria in the intestines. Also, repeated use can cause intestinal bacteria to become resistant to antibiotics. Reduced use of antibiotics would limit both of these risks.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Crohn Disease
Keywords
Phage, Bacteriophage, AIEC

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare Provider
Allocation
Randomized
Enrollment
30 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Dose is 1mL of placebo given orally twice a day for 15 days
Arm Title
Phage
Arm Type
Experimental
Arm Description
Dose is 1mL of bacteriophage preparation given orally twice a day for 15 days
Intervention Type
Biological
Intervention Name(s)
Placebo
Other Intervention Name(s)
0.9% saline
Intervention Description
Orally, twice a day, for a period of fifteen days
Intervention Type
Biological
Intervention Name(s)
Bacteriophage preparation
Other Intervention Name(s)
EcoActive
Intervention Description
Orally, twice a day, for a period of fifteen days
Primary Outcome Measure Information:
Title
Incidence of adverse events
Description
The number of solicited and unsolicited adverse events will be recorded.
Time Frame
Up to 6 months
Title
Severity of adverse events
Description
The severity will be graded according to the definitions and values stated in CTCAE V04 v4.
Time Frame
Up to 6 months
Title
Effect on Harvey Bradshaw Index (HBI)
Description
The effect on Crohn's disease activity will be evaluated using the HBI.
Time Frame
Up to 6 months
Title
Effect on inflammation, as indicated by C-reactive protein (CRP)
Description
The changes in CRP from baseline will be evaluated.
Time Frame
Up to 6 months
Title
Effect on inflammation, as indicated by fecal calprotectin
Description
The changes in fecal calprotectin levels from baseline will be evaluated.
Time Frame
Up to 6 months
Secondary Outcome Measure Information:
Title
Effect on the incidence and levels of AIEC
Description
The secondary objective is to assess the effect of oral phage administration on the AIEC (CFU/g) in stools of patients receiving phages vs. patients receiving placebo.
Time Frame
Up to 6 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Male or female ≥ 18 years of age Inactive Crohn's disease in clinical and objective remission with a Harvey-Bradshaw Index (HBI) < 4 Permitted CD medications expected to remain stable during the period of the study (see Section 7 "Concomitant Crohn's Disease Medications" for allowed and prohibited drugs). Crohn's disease history ≥ 6-month duration CRP (C-reactive protein) within normal range at the Screening visit (based on normal range of the local laboratory) Fecal calprotectin level ≤ 150 µg/g at the Screening visit AIEC detected in the stool Females of childbearing age must be using an effective method of contraception to prevent pregnancy and agree to continue to practice an acceptable method of contraception for the duration of participation in the study (contraceptive measures considered adequate are: intrauterine devices, hormonal contraceptives, such as contraceptive pills, implants, transdermal patches, hormonal vaginal devices or injections with prolonged release). Negative pregnancy test for women of childbearing age (menarche to menopause) Patient understands the study procedures, and can sign the informed consent, and the authorization to release relevant protected health information to the Study Investigator. Exclusion Criteria: Active Crohn's disease with a Harvey-Bradshaw Index (HBI) ≥ 4 Ongoing gastrointestinal pathology: colorectal tumor, gastrointestinal bleeding Active malignancies or any malignant disease within the past 5 years Indeterminate colitis, ulcerative colitis Colectomy or partial colectomy (less than ileo-transverse colonic anastomosis). Colonic or small bowel stoma Active perianal lesions Women who are pregnant or nursing, or plan to become pregnant during the study period Severe uncontrolled diseases that could increase the risk for subjects participating in the study, including but not limited to: heart diseases, congestive heart failure, hypertension, lung diseases; endocrine diseases; clinically significant renal disease characterized by a glomerular filtration rate < 60mL/min, hepatic diseases, haematological disorders, or other conditions that in the opinion of the Investigator could interfere with the interpretation of the study results. Taking supplemental probiotics in the form of pills or tablets. History or planned procedures specifically aimed at modifying the gastrointestinal microbiota within the past year. Topical gastrointestinal treatment (e.g., enemas) in the 2 weeks prior to the Screening visit or planned during the study period Use of bowel cleansing or preparation for endoscopy, TDM or MRI in the 4 weeks prior to the Screening visit or planned during the study period. Receipt of antibiotics 4 weeks before the Screening visit or planned during the study period. Known allergy or hypersensitivity to an excipient in the study drug or placebo Psychological or linguistic incapability to sign the informed consent. Lack or expected lack of cooperation or compliance with the study. Receipt of mesalamine based therapies within 4 weeks of the screening visit. Severe psychiatric, psychological, or neurological disorders. Alcohol, drug or medication abuse within the past year. Subject who cannot be contacted in case of emergency.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Alexander Sulakvelidze, PhD
Phone
410-625-2533
Email
asulakvelidze@intralytix.com
First Name & Middle Initial & Last Name or Official Title & Degree
Jennifer Schwartz, PhD
Phone
667-215-2597
Email
jschwartz@intralytix.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jean-Frederic Colombel, MD
Organizational Affiliation
MOUNT SINAI HOSPITAL
Official's Role
Principal Investigator
Facility Information:
Facility Name
The Mount Sinai Hospital
City
New York
State/Province
New York
ZIP/Postal Code
10029
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Amy Nolan
Phone
212-824-7699
First Name & Middle Initial & Last Name & Degree
Robert Hirten, MD

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
33310655
Citation
Lenneman BR, Fernbach J, Loessner MJ, Lu TK, Kilcher S. Enhancing phage therapy through synthetic biology and genome engineering. Curr Opin Biotechnol. 2021 Apr;68:151-159. doi: 10.1016/j.copbio.2020.11.003. Epub 2020 Dec 10.
Results Reference
derived

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Safety and Efficacy of EcoActive on Intestinal Adherent Invasive E. Coli in Patients With Inactive Crohn's Disease

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