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Study of OST-122 in Patients With Moderate to Severe Ulcerative Colitis

Primary Purpose

Ulcerative Colitis Chronic Moderate, Ulcerative Colitis Chronic Severe

Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
OST-122
Placebo
Sponsored by
Oncostellae S.L
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Ulcerative Colitis Chronic Moderate

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Willing and able to provide written informed consent and capable of understanding and complying with the protocol;
  2. Patients male and female ≥ 18 and ≤ 75 years at the time of consent;
  3. Patient with previous diagnosis of ulcerative colitis: ulcerative proctitis, left-side ulcerative colitis or extensive/pancolitis (E1, E2 and E3 of Montreal Classification, respectively) established at least 3 months prior to screening and determined by standard clinical, endoscopic, and histological procedures;
  4. Demonstrated inadequate response, loss of response, or intolerance to at least one of the following treatments including, aminosalicylates (ASAs), corticosteroids, immunosuppressants, anti-tumor necrosis factor (TNF)-α agents, integrin inhibitor or anti interleukin 12/23;
  5. If the subject is currently receiving an oral aminosalicylate, he or she is eligible and can stay on that dose of aminosalicylate provided the dose has been stable for at least 1 week prior to screening;
  6. If the subject is currently receiving an oral corticosteroid, he or she is eligible if the dose is equivalent to or less than prednisone 20 mg/day or beclomethasone dipropionate 5 mg/day and stable for at least 1 week prior to Screening visit;
  7. Has an endoscopic Mayo subscore of ≥ 2 and a total Mayo score of 5-10 during screening;
  8. Women who are not postmenopausal (at least 12 months) or surgically sterile must have a negative pregnancy test at screening and at the end of study and either abstain from sexual intercourse or use a highly effective method of birth control (double barrier) for the duration of the study and after 12 weeks after the last dose of study drug;
  9. For men: agreement to remain abstinent or use contraceptive measures and agreement to refrain from donating sperm for the duration of the study and after 12 weeks from the last dose of study drug;
  10. Availability for the entire study period, absence of intellectual problems likely to limit the validity of consent to participate in the study or the compliance with protocol requirements; willingness to adhere to the protocol requirements, ability to cooperate adequately and to understand and follow the instructions of the physician or designee.

Exclusion Criteria:

  1. Has fulminant colitis, toxic megacolon, primary sclerosing cholangitis, Crohn's disease, history of moderate to severe colitis-associated colonic dysplasia, active peptic ulcer disease;
  2. Medications of exclusion:

    1. Topical mesalazine or steroids (i.e., enemas or suppositories) within the 7 days prior to Baseline visit
    2. Azathioprine, 6-mercaptopurine, or methotrexate within 10 days prior to Baseline visit
    3. Intravenous corticosteroids within the 14 days prior to Baseline visit
    4. Tofacitinib or any other JAK inhibitor within 14 days prior to Baseline visit
    5. Anti-diarrheal treatment within 14 days prior to Baseline visit
    6. Received cyclosporine, tacrolimus, mycophenolate mofetil, or thalidomide within 14 days prior to Baseline visit
    7. Adalimumab within the 14 days prior to Baseline visit
    8. Infliximab, golimumab, etanercept, vedolizumab, ustekinumab or certolizumab within the 14 days prior to Baseline visit
    9. NSAIDs on a daily basis from 7 days previous to Baseline visit. Low doses, without anti-inflammatory effect, to treat or prevent other diseases i.e.: ictus, cerebrovascular or cardiovascular diseases, among others; are permitted.
  3. Has a current bacterial, parasitic, fungal, or viral infection;
  4. Is positive for hepatitis A, B or C, HIV (Human Immunodeficiency Virus) or tuberculosis, as assessed by method available at each site;
  5. Patient who has clinically significant diseases and/or infections captured in the medical history or evidence of clinically significant findings on physical examination and/or clinically significant ordinary laboratory evaluations (haematology, biochemistry, and urinalysis) or ECG;
  6. Participated in another clinical trial of an investigational drug (or medical device) within 30 days prior to Baseline (or within 60 days prior to Baseline if investigational drug was a biologic product);
  7. Demonstrated an inadequate response or loss of response to Tofacitinib or any other JAK inhibitor, with the exception of those patients who after a careful evaluation, the PI considers they may obtain a clinical benefit from the therapy;
  8. Use of products, food supplements or medical devices, whose composition includes probiotics in the 1 month prior to Baseline visit;
  9. Patient who has prior extensive colonic resection, subtotal or total colectomy or planned surgery for ulcerative colitis;
  10. Patient who has past or present fistula or abdominal abscess;
  11. Patient who is pregnant or lactating;
  12. Inability to comply with study protocol, in opinion of the investigator;
  13. History of alcohol, drug or chemical abuse within 6 months prior to Screening visit;
  14. History of cancer within the last 5 years. Patients with local basal or squamous cell carcinoma of the skin that has been excised and is considered cured may be included.

Sites / Locations

  • Complejo Hospitalario Universitario de Santiago
  • Hospital Universitario Fundación Alcorcón
  • Complejo Hospitalario de Navarra
  • Hospital Álvaro Cunqueiro
  • Hospital de la Santa Creu i Sant Pau
  • Hospital Reina Sofía
  • Hospital Universitari Doctor Josep Trueta
  • Hospital San Jorge
  • Hospital Infanta Leonor
  • Hospital Universitario La Paz
  • Hospital Universitario Central de Asturias
  • Hospital Universitario Virgen Macarena
  • Hospital Clínico Universitario Lozano Blesa
  • Hospital Universitario Miguel Servet
  • Medical and Diagnostic Center PE PMC "Acinus"
  • Medical Center "Ok!Clinic" of International Institute of Clinical Research LLC

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Placebo Comparator

Arm Label

Experimental arm OST-122

Control arm Placebo

Arm Description

24 subjects will be randomized to receive OST-122 orally daily for 28 days

8 subjects will be randomized to receive placebo orally daily for 28 days

Outcomes

Primary Outcome Measures

Evaluate the safety of OST-122 administered for 28 days in subjects with active UC by assessing the number, severity, and type of adverse events
Number and severity of AEs reported including Clinically Significant Changes in vital signs, physical examination, Laboratory Measurements, and ECGs.

Secondary Outcome Measures

Cmax: Maximum plasma concentration for OST-122
Pharmacokinetic analysis of OST-122 peak concentration in plasma (ng/ml) in every subject enrolled in this trial
Ctrough: Minimum plasma concentration for OST-122
Pharmacokinetic analysis of OST-122 minimum concentration in plasma (ng/ml) in every subject enrolled in this trial
Tmax: Time to reach maximum plasma concentration (Cmax) for OST-122
Pharmacokinetic analysis of OST-122 time (in hours) needed for OST-122 to reach the Cmax (peak concentration) in every subject enrolled in this trial
AUC: Area under the plasma-concentration time-curve
Pharmacokinetic analysis of OST-122 observed area under the plasma-concentration time-curve (ng · h / ml) in every subject enrolled in this trial
Percentage of subjects with improvement in Endoscopic Mayo Score
Study the effect of OST-122 or placebo in Endoscopic Mayo Score Subjects (%) with improvement of endoscopy subscore by ≥1 point Subjects (%) with endoscopy subscore of 0-1
Percentage of subjects with improvement in PRO-2
Study the effect of OST-122 or placebo in PRO-2 [PRO-2: sum of the scores obtained in rectal bleeding and stool frequency (subscores 1+2 of the Mayo Score)] Subjects (%) with PRO-2 subscore of 0-1 Subjects (%) with improvement of PRO-2 subscore by ≥1 point Subjects (%) with improvement of rectal bleeding subscore by ≥1 point Subjects (%) with rectal bleeding subscore of 0-1 Subjects (%) with improvement of stool frequency subscore by ≥1 point Subjects (%) with stool frequency subscore of 0-1
Study the effect of OST-122 or placebo on faecal calprotectin levels
Change from baseline of faecal calprotectin (mg/kg) compared to placebo
Effect of OST-122 or placebo on serum C-reactive protein levels
Change from baseline of serum C-reactive protein (mg/L) compared to placebo

Full Information

First Posted
March 24, 2020
Last Updated
January 11, 2023
Sponsor
Oncostellae S.L
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1. Study Identification

Unique Protocol Identification Number
NCT04353791
Brief Title
Study of OST-122 in Patients With Moderate to Severe Ulcerative Colitis
Official Title
A Phase Ib/IIa, Randomized, Double Blind, Placebo Controlled, Multicenter Clinical Trial to Evaluate the Safety, Pharmacokinetics and Efficacy of Oral Treatment With OST-122 in Patients With Moderate to Severe Ulcerative Colitis
Study Type
Interventional

2. Study Status

Record Verification Date
January 2022
Overall Recruitment Status
Completed
Study Start Date
September 16, 2020 (Actual)
Primary Completion Date
December 27, 2022 (Actual)
Study Completion Date
December 27, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Oncostellae S.L

4. Oversight

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

5. Study Description

Brief Summary
A Phase Ib/IIa to evaluate the safety and tolerability of oral treatment with OST-122 in patients with moderate to severe ulcerative colitis over 28 days. This trial will also explore pharmacokinetics (PK) profile and preliminary therapeutic efficacy associated with OST-122 through biomarker analysis and clinical, endoscopic and histologic assessments.
Detailed Description
OST-122 is an oral, gut-restricted and subtype-selective Jak3/Tyk2/Ark5 inhibitor for the local treatment of inflammatory bowel disease (IBD) including ulcerative colitis, Crohn's disease and, potentially, fibrotic lesions in Crohn's patients. The compound was well tolerated in a Phase 1 study in healthy volunteers and has been shown to be stable during the GI transit, while no significant plasma levels were detected. The gut-restricted PK profile of OST-122 lowers the risk of systemic toxicities inherent to other JAK inhibitors. In the current proof of concept study, the compound's safety, PK profile and trends of efficacy will be investigated in patients with moderate to severe ulcerative colitis.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Ulcerative Colitis Chronic Moderate, Ulcerative Colitis Chronic Severe

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Experimental arm OST-122
Arm Type
Active Comparator
Arm Description
24 subjects will be randomized to receive OST-122 orally daily for 28 days
Arm Title
Control arm Placebo
Arm Type
Placebo Comparator
Arm Description
8 subjects will be randomized to receive placebo orally daily for 28 days
Intervention Type
Drug
Intervention Name(s)
OST-122
Intervention Description
Active dose
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo
Primary Outcome Measure Information:
Title
Evaluate the safety of OST-122 administered for 28 days in subjects with active UC by assessing the number, severity, and type of adverse events
Description
Number and severity of AEs reported including Clinically Significant Changes in vital signs, physical examination, Laboratory Measurements, and ECGs.
Time Frame
From baseline to end of the follow-up period
Secondary Outcome Measure Information:
Title
Cmax: Maximum plasma concentration for OST-122
Description
Pharmacokinetic analysis of OST-122 peak concentration in plasma (ng/ml) in every subject enrolled in this trial
Time Frame
Day 1 and Day 28
Title
Ctrough: Minimum plasma concentration for OST-122
Description
Pharmacokinetic analysis of OST-122 minimum concentration in plasma (ng/ml) in every subject enrolled in this trial
Time Frame
Day 1 and Day 28
Title
Tmax: Time to reach maximum plasma concentration (Cmax) for OST-122
Description
Pharmacokinetic analysis of OST-122 time (in hours) needed for OST-122 to reach the Cmax (peak concentration) in every subject enrolled in this trial
Time Frame
Day 1 and Day 28
Title
AUC: Area under the plasma-concentration time-curve
Description
Pharmacokinetic analysis of OST-122 observed area under the plasma-concentration time-curve (ng · h / ml) in every subject enrolled in this trial
Time Frame
Day 1 and Day 28
Title
Percentage of subjects with improvement in Endoscopic Mayo Score
Description
Study the effect of OST-122 or placebo in Endoscopic Mayo Score Subjects (%) with improvement of endoscopy subscore by ≥1 point Subjects (%) with endoscopy subscore of 0-1
Time Frame
Day 0 and Day 28
Title
Percentage of subjects with improvement in PRO-2
Description
Study the effect of OST-122 or placebo in PRO-2 [PRO-2: sum of the scores obtained in rectal bleeding and stool frequency (subscores 1+2 of the Mayo Score)] Subjects (%) with PRO-2 subscore of 0-1 Subjects (%) with improvement of PRO-2 subscore by ≥1 point Subjects (%) with improvement of rectal bleeding subscore by ≥1 point Subjects (%) with rectal bleeding subscore of 0-1 Subjects (%) with improvement of stool frequency subscore by ≥1 point Subjects (%) with stool frequency subscore of 0-1
Time Frame
Day 0, Day 7, Day 14, Day 21, Day 28
Title
Study the effect of OST-122 or placebo on faecal calprotectin levels
Description
Change from baseline of faecal calprotectin (mg/kg) compared to placebo
Time Frame
Day 1, Day 7, Day 14, Day 21, Day 28
Title
Effect of OST-122 or placebo on serum C-reactive protein levels
Description
Change from baseline of serum C-reactive protein (mg/L) compared to placebo
Time Frame
Day 0, Day 14, Day 28

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Willing and able to provide written informed consent and capable of understanding and complying with the protocol; Patients male and female ≥ 18 and ≤ 75 years at the time of consent; Patient with previous diagnosis of ulcerative colitis: ulcerative proctitis, left-side ulcerative colitis or extensive/pancolitis (E1, E2 and E3 of Montreal Classification, respectively) established at least 3 months prior to screening and determined by standard clinical, endoscopic, and histological procedures; Demonstrated inadequate response, loss of response, or intolerance to at least one of the following treatments including, aminosalicylates (ASAs), corticosteroids, immunosuppressants, anti-tumor necrosis factor (TNF)-α agents, integrin inhibitor or anti interleukin 12/23; If the subject is currently receiving an oral aminosalicylate, he or she is eligible and can stay on that dose of aminosalicylate provided the dose has been stable for at least 1 week prior to screening; If the subject is currently receiving an oral corticosteroid, he or she is eligible if the dose is equivalent to or less than prednisone 20 mg/day or beclomethasone dipropionate 5 mg/day and stable for at least 1 week prior to Screening visit; Has an endoscopic Mayo subscore of ≥ 2 and a total Mayo score of 5-10 during screening; Women who are not postmenopausal (at least 12 months) or surgically sterile must have a negative pregnancy test at screening and at the end of study and either abstain from sexual intercourse or use a highly effective method of birth control (double barrier) for the duration of the study and after 12 weeks after the last dose of study drug; For men: agreement to remain abstinent or use contraceptive measures and agreement to refrain from donating sperm for the duration of the study and after 12 weeks from the last dose of study drug; Availability for the entire study period, absence of intellectual problems likely to limit the validity of consent to participate in the study or the compliance with protocol requirements; willingness to adhere to the protocol requirements, ability to cooperate adequately and to understand and follow the instructions of the physician or designee. Exclusion Criteria: Has fulminant colitis, toxic megacolon, primary sclerosing cholangitis, Crohn's disease, history of moderate to severe colitis-associated colonic dysplasia, active peptic ulcer disease; Medications of exclusion: Topical mesalazine or steroids (i.e., enemas or suppositories) within the 7 days prior to Baseline visit Azathioprine, 6-mercaptopurine, or methotrexate within 10 days prior to Baseline visit Intravenous corticosteroids within the 14 days prior to Baseline visit Tofacitinib or any other JAK inhibitor within 14 days prior to Baseline visit Anti-diarrheal treatment within 14 days prior to Baseline visit Received cyclosporine, tacrolimus, mycophenolate mofetil, or thalidomide within 14 days prior to Baseline visit Adalimumab within the 14 days prior to Baseline visit Infliximab, golimumab, etanercept, vedolizumab, ustekinumab or certolizumab within the 14 days prior to Baseline visit NSAIDs on a daily basis from 7 days previous to Baseline visit. Low doses, without anti-inflammatory effect, to treat or prevent other diseases i.e.: ictus, cerebrovascular or cardiovascular diseases, among others; are permitted. Has a current bacterial, parasitic, fungal, or viral infection; Is positive for hepatitis A, B or C, HIV (Human Immunodeficiency Virus) or tuberculosis, as assessed by method available at each site; Patient who has clinically significant diseases and/or infections captured in the medical history or evidence of clinically significant findings on physical examination and/or clinically significant ordinary laboratory evaluations (haematology, biochemistry, and urinalysis) or ECG; Participated in another clinical trial of an investigational drug (or medical device) within 30 days prior to Baseline (or within 60 days prior to Baseline if investigational drug was a biologic product); Demonstrated an inadequate response or loss of response to Tofacitinib or any other JAK inhibitor, with the exception of those patients who after a careful evaluation, the PI considers they may obtain a clinical benefit from the therapy; Use of products, food supplements or medical devices, whose composition includes probiotics in the 1 month prior to Baseline visit; Patient who has prior extensive colonic resection, subtotal or total colectomy or planned surgery for ulcerative colitis; Patient who has past or present fistula or abdominal abscess; Patient who is pregnant or lactating; Inability to comply with study protocol, in opinion of the investigator; History of alcohol, drug or chemical abuse within 6 months prior to Screening visit; History of cancer within the last 5 years. Patients with local basal or squamous cell carcinoma of the skin that has been excised and is considered cured may be included.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ascensión Heredia Rodríguez, PhD
Organizational Affiliation
Oncostellae S.L
Official's Role
Study Director
Facility Information:
Facility Name
Complejo Hospitalario Universitario de Santiago
City
Santiago de Compostela
State/Province
A Coruña
Country
Spain
Facility Name
Hospital Universitario Fundación Alcorcón
City
Alcorcón
State/Province
Madrid
Country
Spain
Facility Name
Complejo Hospitalario de Navarra
City
Pamplona
State/Province
Navarra
Country
Spain
Facility Name
Hospital Álvaro Cunqueiro
City
Vigo
State/Province
Pontevedra
Country
Spain
Facility Name
Hospital de la Santa Creu i Sant Pau
City
Barcelona
Country
Spain
Facility Name
Hospital Reina Sofía
City
Córdoba
Country
Spain
Facility Name
Hospital Universitari Doctor Josep Trueta
City
Girona
ZIP/Postal Code
17007
Country
Spain
Facility Name
Hospital San Jorge
City
Huesca
Country
Spain
Facility Name
Hospital Infanta Leonor
City
Madrid
Country
Spain
Facility Name
Hospital Universitario La Paz
City
Madrid
Country
Spain
Facility Name
Hospital Universitario Central de Asturias
City
Oviedo
Country
Spain
Facility Name
Hospital Universitario Virgen Macarena
City
Sevilla
ZIP/Postal Code
41009
Country
Spain
Facility Name
Hospital Clínico Universitario Lozano Blesa
City
Zaragoza
Country
Spain
Facility Name
Hospital Universitario Miguel Servet
City
Zaragoza
Country
Spain
Facility Name
Medical and Diagnostic Center PE PMC "Acinus"
City
Kropyvnytskyi
Country
Ukraine
Facility Name
Medical Center "Ok!Clinic" of International Institute of Clinical Research LLC
City
Kyiv
Country
Ukraine

12. IPD Sharing Statement

Learn more about this trial

Study of OST-122 in Patients With Moderate to Severe Ulcerative Colitis

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