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A Study of Oral Foralumab in Participants With Moderate to Severely Active Crohn's Disease

Primary Purpose

Crohn's Disease

Status
Withdrawn
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
Foralumab
Sponsored by
Tiziana Life Sciences LTD
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Crohn's Disease focused on measuring Anti-CD3 Monoclonal Antibody, Inflammatory bowel disease, Oral anti-CD3

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Participant has been diagnosed with active CD as confirmed by endoscopic examination with histological confirmation for at least 12 weeks before the screening visit; only study participant who has endoscopic examination by colonoscopy of disease location that includes ileocolon and/or colon and who has a Simple Endoscopic Score for Crohn's Disease (SES-CD) ≥3 will be enrolled in the study.
  • Participant has a CDAI ≥220 but ≤450 points (that is, participant has moderate to severely active disease despite current treatment).
  • Participant is naïve to anti-CD3 therapy.
  • Non-smoker or use of nicotine or other nicotine-containing products (snuff, chewing tobacco, cigars, pipes, e-cigarettes or nicotine-replacement products such as nicotine chewing gum and nicotine plasters) will not be allowed from 3 months before the screening visit until the final follow-up visit.
  • Participant's current regimen of concomitant medication(s) falls within the definitions provided in the protocol.
  • Participant must weigh ≥50 kg at the time of signing informed consent.
  • Male or female

    1. Sexually active male participant must agree to use highly effective contraception as detailed in of this protocol during the treatment period and for at least 10 weeks after the last dose of study medication (or longer if required by local approved label).
    2. A female participant is eligible to participate if she is not pregnant, not breastfeeding, and at least one of the following conditions applies:

    i) Not a woman of childbearing potential (WOCBP). ii) A WOCBP who agrees to follow the guidance for highly effective contraception during the treatment period and for at least 10 weeks after the last dose of study medication (or longer if required by local approved label).

Exclusion Criteria:

  • Participant has symptomatic coronavirus disease of 2019 (COVID-19) or a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test result prior to screening.
  • Participant has a suspected or confirmed diagnosis of ulcerative colitis (UC), indeterminate colitis, ischemic colitis, radiation colitis, diverticular disease associated with colitis, or microscopic colitis.
  • Participant with any known fistula involving the gastrointestinal (GI) tract (except for perianal fistula).
  • Participant with symptomatic stricturing type disease at the time of the screening visit.
  • Participant has had an extensive colonic resection, subtotal or total colectomy, diagnosis of short bowel syndrome or a history of >3 small bowel resections.
  • Participant has a functional colostomy or ileostomy. Exception: A participant who has had a temporary stoma in the past, which has been reversed, may be enrolled.
  • Participant has had a surgical bowel resection within 6 months before the screening visit or is planning any resection at a time while enrolled in the study.
  • Participant with clinical suspicion of intra-abdominal abscess(es). If a participant receives treatment for the abscess, they may be rescreened.
  • Participant currently requires or is anticipated to require surgical intervention for CD during the study.
  • Participant has a current or recent history (within 6 months before the screening visit) of clinically relevant renal, hepatic, hematological, GI (other than CD), endocrine, pulmonary, neurological, or cerebral disease including blood dyscrasia (for example, pancytopenia, aplastic anemia), demyelinating disease (for example, multiple sclerosis, myelitis, optic neuritis), or ischemic heart disease.
  • Participant has known history of or current clinically active infection with histoplasma, coccidioides, paracoccidioides, pneumocystis, tuberculous mycobacteria, nontuberculous mycobacteria, blastomyces, aspergillus, legionella, or listeria.
  • Participant with evidence of an acquired or congenital immunodeficiency state, including, but not limited to, known human immunodeficiency virus (HIV) infection, agammaglobulinemia, organ transplantation, T cell deficiencies, or human T cell lymphotropic virus type 1.
  • Participant has a history of chronic or recurrent infections (more than 3 episodes requiring antibiotics/antivirals during the preceding year), recent serious or life-threatening infection within the 4 weeks prior to the screening visit (including Herpes zoster), infection requiring intravenous (IV) antibiotic use within the 4 weeks prior to the screening visit or oral antibiotic use within the 2 weeks prior to the screening visit.
  • Participant has a concurrent malignancy or a history of any malignancy at any time (including nonmelanoma skin cancer).
  • Participant has concurrent bowel dysplasia or a history of bowel dysplasia in the 5 years before the screening visit.
  • Participant has a history of a lymphoproliferative disorder, including lymphoma, or signs and symptoms suggestive of lymphoproliferative disease at any time.
  • Participant has a known hypersensitivity to any excipients of the investigational medicinal product (IMP) or its ingredients.
  • Participant is currently receiving chronic concomitant systemic antibiotic therapy for diseases other than CD or acne.
  • Participant received any live (includes attenuated) vaccination within the 10 weeks prior to the screening visit or intending to receive during the study (inactivated vaccinations are permitted at any time prior to and during the study) or within 3 months after last dose of certolizumab pegol (CZP) or foralumab.
  • Participant has a positive fecal laboratory test result for enteric pathogens and/or ova and parasites at the screening visit.
  • Participant who has evidence of, or treatment for clostridium difficile infection or other intestinal pathogen, within 28 days prior to first dose of study medication.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm 4

    Arm Type

    Experimental

    Experimental

    Experimental

    Experimental

    Arm Label

    Cohort 1: Foralumab Dose Level 1

    Cohort 2: Foralumab Dose Level 2

    Cohort 3: Foralumab Dose Level 3

    Cohort 4: Foralumab Dose Level 4

    Arm Description

    Participants will receive foralumab enteric coated capsules at dose level 1, administered orally once daily for 2 weeks (5 consecutive days in each week with a 2-day undosed safety assessment period after each 5 day treatment period).

    Participants will receive foralumab enteric coated capsules at dose level 2, administered orally once daily for 2 weeks (5 consecutive days in each week with a 2-day undosed safety assessment period after each 5 day treatment period).

    Participants will receive foralumab enteric coated capsules at dose level 3, administered orally once daily for 2 weeks (5 consecutive days in each week with a 2-day undosed safety assessment period after each 5 day treatment period).

    Participants will receive foralumab enteric coated capsules at dose level 4, administered orally once daily for 2 weeks (5 consecutive days in each week with a 2-day undosed safety assessment period after each 5 day treatment period).

    Outcomes

    Primary Outcome Measures

    Number of Participants With Adverse Events (AEs) and Serious Adverse Events (SAEs)
    Adverse events categorized and graded via CTCAE

    Secondary Outcome Measures

    Change From Baseline in Crohn's Disease Activity Index (CDAI) Score at Day 5 and Day 12
    The CDAI score is used to quantify the symptoms of participants with Crohn's Disease. CDAI scores generally range from 0 to 600 points. A score of 150 or below indicates remission and a score above 450 indicates extremely severe disease. A decrease in CDAI over time indicates improvement in disease activity.

    Full Information

    First Posted
    August 24, 2021
    Last Updated
    October 18, 2022
    Sponsor
    Tiziana Life Sciences LTD
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    1. Study Identification

    Unique Protocol Identification Number
    NCT05028946
    Brief Title
    A Study of Oral Foralumab in Participants With Moderate to Severely Active Crohn's Disease
    Official Title
    A Phase IB Multiple Ascending Dose Study of Safety and Tolerability of Orally Administered Foralumab, a Fully Human Anti-CD3 Monoclonal Antibody, in Subjects With Moderate to Severely Active Crohn's Disease
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    October 2022
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    For business reasons
    Study Start Date
    May 1, 2022 (Anticipated)
    Primary Completion Date
    July 7, 2023 (Anticipated)
    Study Completion Date
    November 7, 2023 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Tiziana Life Sciences LTD

    4. Oversight

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

    5. Study Description

    Brief Summary
    The primary objective of this study is to establish the safety and tolerability of multiple ascending doses (MAD) of foralumab enteric coated capsules administered orally, once daily for 5 days per week over 2 weeks in participants with moderate to severely active Crohn's Disease (CD).
    Detailed Description
    Four different doses of foralumab enteric coated capsules will be studied for safety and tolerability in a MAD format. Participants in the sequential MAD cohorts will receive treatment when the safety data of one cohort are reviewed by the Data Safety Monitoring Board (DSMB) and are deemed favorable to proceed with the next treatment in the subsequent cohort.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Crohn's Disease
    Keywords
    Anti-CD3 Monoclonal Antibody, Inflammatory bowel disease, Oral anti-CD3

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 1
    Interventional Study Model
    Sequential Assignment
    Masking
    None (Open Label)
    Allocation
    Non-Randomized
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Cohort 1: Foralumab Dose Level 1
    Arm Type
    Experimental
    Arm Description
    Participants will receive foralumab enteric coated capsules at dose level 1, administered orally once daily for 2 weeks (5 consecutive days in each week with a 2-day undosed safety assessment period after each 5 day treatment period).
    Arm Title
    Cohort 2: Foralumab Dose Level 2
    Arm Type
    Experimental
    Arm Description
    Participants will receive foralumab enteric coated capsules at dose level 2, administered orally once daily for 2 weeks (5 consecutive days in each week with a 2-day undosed safety assessment period after each 5 day treatment period).
    Arm Title
    Cohort 3: Foralumab Dose Level 3
    Arm Type
    Experimental
    Arm Description
    Participants will receive foralumab enteric coated capsules at dose level 3, administered orally once daily for 2 weeks (5 consecutive days in each week with a 2-day undosed safety assessment period after each 5 day treatment period).
    Arm Title
    Cohort 4: Foralumab Dose Level 4
    Arm Type
    Experimental
    Arm Description
    Participants will receive foralumab enteric coated capsules at dose level 4, administered orally once daily for 2 weeks (5 consecutive days in each week with a 2-day undosed safety assessment period after each 5 day treatment period).
    Intervention Type
    Drug
    Intervention Name(s)
    Foralumab
    Other Intervention Name(s)
    Human anti-CD3 monoclonal antibody (mAb)
    Intervention Description
    Foralumab will be administered per dose and schedule specified in the arm description.
    Primary Outcome Measure Information:
    Title
    Number of Participants With Adverse Events (AEs) and Serious Adverse Events (SAEs)
    Description
    Adverse events categorized and graded via CTCAE
    Time Frame
    Day 1 up to Day 14
    Secondary Outcome Measure Information:
    Title
    Change From Baseline in Crohn's Disease Activity Index (CDAI) Score at Day 5 and Day 12
    Description
    The CDAI score is used to quantify the symptoms of participants with Crohn's Disease. CDAI scores generally range from 0 to 600 points. A score of 150 or below indicates remission and a score above 450 indicates extremely severe disease. A decrease in CDAI over time indicates improvement in disease activity.
    Time Frame
    Baseline, Day 5 and Day 12

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    70 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Participant has been diagnosed with active CD as confirmed by endoscopic examination with histological confirmation for at least 12 weeks before the screening visit; only study participant who has endoscopic examination by colonoscopy of disease location that includes ileocolon and/or colon and who has a Simple Endoscopic Score for Crohn's Disease (SES-CD) ≥3 will be enrolled in the study. Participant has a CDAI ≥220 but ≤450 points (that is, participant has moderate to severely active disease despite current treatment). Participant is naïve to anti-CD3 therapy. Non-smoker or use of nicotine or other nicotine-containing products (snuff, chewing tobacco, cigars, pipes, e-cigarettes or nicotine-replacement products such as nicotine chewing gum and nicotine plasters) will not be allowed from 3 months before the screening visit until the final follow-up visit. Participant's current regimen of concomitant medication(s) falls within the definitions provided in the protocol. Participant must weigh ≥50 kg at the time of signing informed consent. Male or female Sexually active male participant must agree to use highly effective contraception as detailed in of this protocol during the treatment period and for at least 10 weeks after the last dose of study medication (or longer if required by local approved label). A female participant is eligible to participate if she is not pregnant, not breastfeeding, and at least one of the following conditions applies: i) Not a woman of childbearing potential (WOCBP). ii) A WOCBP who agrees to follow the guidance for highly effective contraception during the treatment period and for at least 10 weeks after the last dose of study medication (or longer if required by local approved label). Exclusion Criteria: Participant has symptomatic coronavirus disease of 2019 (COVID-19) or a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test result prior to screening. Participant has a suspected or confirmed diagnosis of ulcerative colitis (UC), indeterminate colitis, ischemic colitis, radiation colitis, diverticular disease associated with colitis, or microscopic colitis. Participant with any known fistula involving the gastrointestinal (GI) tract (except for perianal fistula). Participant with symptomatic stricturing type disease at the time of the screening visit. Participant has had an extensive colonic resection, subtotal or total colectomy, diagnosis of short bowel syndrome or a history of >3 small bowel resections. Participant has a functional colostomy or ileostomy. Exception: A participant who has had a temporary stoma in the past, which has been reversed, may be enrolled. Participant has had a surgical bowel resection within 6 months before the screening visit or is planning any resection at a time while enrolled in the study. Participant with clinical suspicion of intra-abdominal abscess(es). If a participant receives treatment for the abscess, they may be rescreened. Participant currently requires or is anticipated to require surgical intervention for CD during the study. Participant has a current or recent history (within 6 months before the screening visit) of clinically relevant renal, hepatic, hematological, GI (other than CD), endocrine, pulmonary, neurological, or cerebral disease including blood dyscrasia (for example, pancytopenia, aplastic anemia), demyelinating disease (for example, multiple sclerosis, myelitis, optic neuritis), or ischemic heart disease. Participant has known history of or current clinically active infection with histoplasma, coccidioides, paracoccidioides, pneumocystis, tuberculous mycobacteria, nontuberculous mycobacteria, blastomyces, aspergillus, legionella, or listeria. Participant with evidence of an acquired or congenital immunodeficiency state, including, but not limited to, known human immunodeficiency virus (HIV) infection, agammaglobulinemia, organ transplantation, T cell deficiencies, or human T cell lymphotropic virus type 1. Participant has a history of chronic or recurrent infections (more than 3 episodes requiring antibiotics/antivirals during the preceding year), recent serious or life-threatening infection within the 4 weeks prior to the screening visit (including Herpes zoster), infection requiring intravenous (IV) antibiotic use within the 4 weeks prior to the screening visit or oral antibiotic use within the 2 weeks prior to the screening visit. Participant has a concurrent malignancy or a history of any malignancy at any time (including nonmelanoma skin cancer). Participant has concurrent bowel dysplasia or a history of bowel dysplasia in the 5 years before the screening visit. Participant has a history of a lymphoproliferative disorder, including lymphoma, or signs and symptoms suggestive of lymphoproliferative disease at any time. Participant has a known hypersensitivity to any excipients of the investigational medicinal product (IMP) or its ingredients. Participant is currently receiving chronic concomitant systemic antibiotic therapy for diseases other than CD or acne. Participant received any live (includes attenuated) vaccination within the 10 weeks prior to the screening visit or intending to receive during the study (inactivated vaccinations are permitted at any time prior to and during the study) or within 3 months after last dose of certolizumab pegol (CZP) or foralumab. Participant has a positive fecal laboratory test result for enteric pathogens and/or ova and parasites at the screening visit. Participant who has evidence of, or treatment for clostridium difficile infection or other intestinal pathogen, within 28 days prior to first dose of study medication.

    12. IPD Sharing Statement

    Plan to Share IPD
    No

    Learn more about this trial

    A Study of Oral Foralumab in Participants With Moderate to Severely Active Crohn's Disease

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