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A Phase 2a Study to Evaluate the Safety, Tolerability, Pharmacodynamics and Efficacy of AG011 in Ulcerative Colitis

Primary Purpose

Moderately Active Ulcerative Colitis

Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
AG011
Placebo
Sponsored by
ActoGeniX N.V.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Moderately Active Ulcerative Colitis focused on measuring AG011, Ulcerative Colitis, human Interleukin-10

Eligibility Criteria

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

Inclusion Criteria:

  • Male or non-pregnant, non-lactating females, 18 years of age or older. Females of child bearing potential must have negative serum or urine pregnancy tests at the screening visit and throughout the study, and must use a hormonal (oral, implantable or injectable) or barrier method of birth control throughout the study. Females unable to bear children must have documentation of such in the case report form (i.e. tubal ligation, hysterectomy, or post menopausal [defined as a minimum of one year since the last menstrual period]).
  • Documented diagnosis of UC with a minimum disease extent of 15 cm from the anal verge.
  • Presence of friability on endoscopy, with minimum of Grade 2 (modified Baron score) changes at approximately 15 cm or more from the anal verge.
  • Minimum Mayo Clinic Disease Activity Score of 5, with a score of at least 1 on both the stool frequency and rectal bleeding components.
  • Receiving 5-ASA treatment for at least two months and a stable dose of oral 5 ASA for at least two weeks prior to randomization. Concurrent treatment with prednisone, or equivalent glucocorticoid ≤ 20 mg/day is acceptable as follows: minimum dosing of 4 weeks prior to screening AND stable dose for 2 weeks prior to screening AND expected to remain on a constant dose during the trial. Use of 5-ASA compounds is not required for those subjects who have failed treatment with 5-ASA compounds, or are allergic or intolerant.
  • Hepatic function (AST, ALT, total bilirubin, alkaline phosphatase, LDH) ≤ 2 times the upper limit of the normal range.
  • Adequate renal function, as evidenced by serum creatinine ≤ 1.5 times the upper limit of the normal range.
  • Hemoglobin ≥ 10 g/dL.
  • ANC ≥ 1.5 x 10E9/L (1,500 mm3).
  • Lymphocyte count ≥ 0.1 x 10E3/μL.
  • Platelet count ≥ 100 x 10E9/L (100,000/mm3).
  • Ability of subject to participate fully in all aspects of this clinical trial.
  • Written informed consent must be obtained and documented.

Exclusion Criteria:

  • Exhibiting severe ulcerative colitis as defined by the following criteria: ≥ 6 bloody stools daily with one or more of the following: oral temperature > 37.8 °C or > 100.0 °F, pulse > 90/min, hemoglobin < 10 g/dL.
  • Crohn's disease.
  • History of colectomy or partial colectomy.
  • Clostridium (C.) difficile positive at screening visit or treated for C. difficile within the 4 weeks prior to randomization
  • Treatment with antibiotics or probiotics at screening
  • Treatment with cyclosporine, methotrexate, azathioprine, 6-MP, infliximab, adalimumab or other immunosuppressants/biologics within 4 weeks prior to randomization
  • Use of rectal steroids or 5-ASA enemas within 2 weeks prior to randomization.
  • Clinically significant active infection.
  • Known chronic liver disease.
  • Serious underlying disease other than UC in the opinion of the investigator.
  • Alcohol or illicit drug consumption, which in the opinion of the investigator, may interfere with the subject's ability to comply with the study procedures
  • Active psychiatric problems, which in the opinion of the investigator, may interfere with the subject's ability to comply with the study procedures.
  • History of malignancy other than basal or squamous cell cancer of the skin that has been removed, or carcinoma in situ of the cervix that has been adequately treated.
  • History of dysplasia in colonic biopsies.
  • Receiving any investigational therapy or any approved therapy for investigational use within 30 days or 5 half-lives prior to randomization (whichever is longer).
  • Pregnant or lactating women.
  • Prior enrollment in the current study and had received study treatment.

Sites / Locations

  • Imelda Bonheiden
  • UCL St. Luc
  • UZ Antwerpen
  • UZ Gent
  • AZ Groeninge Campus St.-Niklaas
  • UZ Leuven
  • GI Research Institute
  • The office of Dr. Donald Daly
  • Hotel Dieu Hospital
  • LHSC - South Street Campus
  • LHSC - University Campus
  • Ottawa Hospital General Campus
  • Mount Sinai Hospital
  • Hôpital St-Sacrement
  • Leiden University Medical Center
  • Lund University Hospital
  • Orebro University Hospital
  • Sophiahemmet

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm Type

Experimental

Placebo Comparator

Experimental

Placebo Comparator

Experimental

Placebo Comparator

Arm Label

1

2

3

4

5

6

Arm Description

AG011: low dose

Placebo: low dose

AG011: mid dose

Placebo: mid dose

AG011: high dose

Placebo: high dose

Outcomes

Primary Outcome Measures

SAFETY: Adverse Events
SAFETY: Physical Examination (complete or brief)
SAFETY: Vital signs
SAFETY: Clinical Laboratory Tests (hematology, serum chemistry, urinalysis)
SAFETY: Analysis of hIL-10 (systemic exposure) and anti-hIL-10 antibodies (immunogenicity) in plasma
SAFETY: Stool Diary
SAFETY: Other Safety Measures (Stool samples for culture, ova and parasite evaluation and Clostridium difficile assay.
BIOLOGICAL CONTAINMENT: Evaluation of living, genetically modified micro-organisms in stool samples
PHARMACODYNAMICS: Biomarkers in blood and colon biopsy samples

Secondary Outcome Measures

EFFICACY: Flexible sigmoidoscopy (assessment of inflammation)
EFFICACY: Histological assessment of inflammation (biopsy samples)
EFFICACY: Disease activity assessments (MCDAS, UCCS, Investigator and Subject Global Ratings)
EFFICACY: Laboratory assessments (CRP and fecal calprotectin)

Full Information

First Posted
August 4, 2008
Last Updated
September 9, 2009
Sponsor
ActoGeniX N.V.
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1. Study Identification

Unique Protocol Identification Number
NCT00729872
Brief Title
A Phase 2a Study to Evaluate the Safety, Tolerability, Pharmacodynamics and Efficacy of AG011 in Ulcerative Colitis
Official Title
A Phase 2a Randomized, Placebo-Controlled, Double-Blind, Multi-Center Dose Escalation Study, to Evaluate the Safety, Tolerability, Pharmacodynamics and Efficacy of AG011, in Subjects With Moderately Active Ulcerative Colitis
Study Type
Interventional

2. Study Status

Record Verification Date
September 2009
Overall Recruitment Status
Completed
Study Start Date
July 2008 (undefined)
Primary Completion Date
September 2009 (Actual)
Study Completion Date
September 2009 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
ActoGeniX N.V.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to verify the safety and tolerability of AG011 (genetically modified L. lactis that has been engineered to secrete human Interleukin-10), and to determine whether AG011 can successfully treat the symptoms of moderately active Ulcerative Colitis (UC).
Detailed Description
The purpose of this study is to verify the safety and tolerability of AG011 and to determine whether AG011 can successfully treat the symptoms of Ulcerative Colitis (UC). Three different dosages will be used in reference to a placebo. AG011 is an experimental medication. It has been developed as potential treatment for moderately active UC. AG011 is the clinical formulation of a genetically modified L. lactis that has been engineered to secrete human Interleukin-10 (hIL-10). By delivering hIL-10 locally at inflamed tissue in the intestine, it is believed that, compared to hIL-10 given by injection, the effectiveness may be increased, with fewer adverse effects. Study medication will be provided in capsule and enema (topical rectal application) forms by ActoGeniX NV. Subjects will be entered sequentially into one of three dose groups, starting from the lowest dose group. Within each of the first two dose groups, 15 subjects will be entered. Within the highest dose group, 30 subjects will be entered. Within each dose group, subjects will be randomly assigned in a 2:1 ratio to receive either AG011 or placebo for 28 days. Timely monitoring of safety data is planned for the study, such that subject enrollment can continue without interruption for the purpose of data collection between dose groups. Safety and tolerability will be closely monitored by the Clinical Safety Specialist (CSS) assigned to the study. The CSS will review adverse events and laboratory safety data and report any safety concerns to the Sponsor and a Data Safety Monitoring Committee (DSMC). At least 8 subjects must have safely completed study treatment for 28 days at a specific dose level, prior to escalation to the next dose group. The DSMC will convene to assess safety data when 8 subjects have completed study treatment for 28 days at the specific dose level. The role of the DSMC for the study will be complete when all subjects in the study have completed study treatment. For those patients randomized within the active group, UC symptoms could improve. As a result of the information gathered by this study, the knowledge and understanding of UC could improve.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Moderately Active Ulcerative Colitis
Keywords
AG011, Ulcerative Colitis, human Interleukin-10

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
60 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
1
Arm Type
Experimental
Arm Description
AG011: low dose
Arm Title
2
Arm Type
Placebo Comparator
Arm Description
Placebo: low dose
Arm Title
3
Arm Type
Experimental
Arm Description
AG011: mid dose
Arm Title
4
Arm Type
Placebo Comparator
Arm Description
Placebo: mid dose
Arm Title
5
Arm Type
Experimental
Arm Description
AG011: high dose
Arm Title
6
Arm Type
Placebo Comparator
Arm Description
Placebo: high dose
Intervention Type
Biological
Intervention Name(s)
AG011
Intervention Description
Capsules (low, mid or high dose), twice daily for 28 days, combined with Enema (low, mid or high dose respectively), once daily for 28 days.
Intervention Type
Other
Intervention Name(s)
Placebo
Intervention Description
Capsules (matching placebo for low, mid or high dose), twice daily for 28 days, combined with Enema (matching placebo for low, mid or high dose respectively), once daily for 28 days.
Primary Outcome Measure Information:
Title
SAFETY: Adverse Events
Time Frame
day 1, 8 15, 22, 29, 57
Title
SAFETY: Physical Examination (complete or brief)
Time Frame
day -7, 1, 8, 15, 22, 29
Title
SAFETY: Vital signs
Time Frame
day -7, 1, 8, 15, 22, 29, 57
Title
SAFETY: Clinical Laboratory Tests (hematology, serum chemistry, urinalysis)
Time Frame
day -7, 1, 8, 15, 22, 29, 57
Title
SAFETY: Analysis of hIL-10 (systemic exposure) and anti-hIL-10 antibodies (immunogenicity) in plasma
Time Frame
day 1, day 29
Title
SAFETY: Stool Diary
Time Frame
From day -7 until day 29
Title
SAFETY: Other Safety Measures (Stool samples for culture, ova and parasite evaluation and Clostridium difficile assay.
Time Frame
day -7
Title
BIOLOGICAL CONTAINMENT: Evaluation of living, genetically modified micro-organisms in stool samples
Time Frame
day 1, 8, 36
Title
PHARMACODYNAMICS: Biomarkers in blood and colon biopsy samples
Time Frame
day -7, 29
Secondary Outcome Measure Information:
Title
EFFICACY: Flexible sigmoidoscopy (assessment of inflammation)
Time Frame
Day -7, 29
Title
EFFICACY: Histological assessment of inflammation (biopsy samples)
Time Frame
Day -7, 29
Title
EFFICACY: Disease activity assessments (MCDAS, UCCS, Investigator and Subject Global Ratings)
Time Frame
Day -7, 1, 8, 15, 22, 29, 57
Title
EFFICACY: Laboratory assessments (CRP and fecal calprotectin)
Time Frame
Day 1, 15, 29, 57

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or non-pregnant, non-lactating females, 18 years of age or older. Females of child bearing potential must have negative serum or urine pregnancy tests at the screening visit and throughout the study, and must use a hormonal (oral, implantable or injectable) or barrier method of birth control throughout the study. Females unable to bear children must have documentation of such in the case report form (i.e. tubal ligation, hysterectomy, or post menopausal [defined as a minimum of one year since the last menstrual period]). Documented diagnosis of UC with a minimum disease extent of 15 cm from the anal verge. Presence of friability on endoscopy, with minimum of Grade 2 (modified Baron score) changes at approximately 15 cm or more from the anal verge. Minimum Mayo Clinic Disease Activity Score of 5, with a score of at least 1 on both the stool frequency and rectal bleeding components. Receiving 5-ASA treatment for at least two months and a stable dose of oral 5 ASA for at least two weeks prior to randomization. Concurrent treatment with prednisone, or equivalent glucocorticoid ≤ 20 mg/day is acceptable as follows: minimum dosing of 4 weeks prior to screening AND stable dose for 2 weeks prior to screening AND expected to remain on a constant dose during the trial. Use of 5-ASA compounds is not required for those subjects who have failed treatment with 5-ASA compounds, or are allergic or intolerant. Hepatic function (AST, ALT, total bilirubin, alkaline phosphatase, LDH) ≤ 2 times the upper limit of the normal range. Adequate renal function, as evidenced by serum creatinine ≤ 1.5 times the upper limit of the normal range. Hemoglobin ≥ 10 g/dL. ANC ≥ 1.5 x 10E9/L (1,500 mm3). Lymphocyte count ≥ 0.1 x 10E3/μL. Platelet count ≥ 100 x 10E9/L (100,000/mm3). Ability of subject to participate fully in all aspects of this clinical trial. Written informed consent must be obtained and documented. Exclusion Criteria: Exhibiting severe ulcerative colitis as defined by the following criteria: ≥ 6 bloody stools daily with one or more of the following: oral temperature > 37.8 °C or > 100.0 °F, pulse > 90/min, hemoglobin < 10 g/dL. Crohn's disease. History of colectomy or partial colectomy. Clostridium (C.) difficile positive at screening visit or treated for C. difficile within the 4 weeks prior to randomization Treatment with antibiotics or probiotics at screening Treatment with cyclosporine, methotrexate, azathioprine, 6-MP, infliximab, adalimumab or other immunosuppressants/biologics within 4 weeks prior to randomization Use of rectal steroids or 5-ASA enemas within 2 weeks prior to randomization. Clinically significant active infection. Known chronic liver disease. Serious underlying disease other than UC in the opinion of the investigator. Alcohol or illicit drug consumption, which in the opinion of the investigator, may interfere with the subject's ability to comply with the study procedures Active psychiatric problems, which in the opinion of the investigator, may interfere with the subject's ability to comply with the study procedures. History of malignancy other than basal or squamous cell cancer of the skin that has been removed, or carcinoma in situ of the cervix that has been adequately treated. History of dysplasia in colonic biopsies. Receiving any investigational therapy or any approved therapy for investigational use within 30 days or 5 half-lives prior to randomization (whichever is longer). Pregnant or lactating women. Prior enrollment in the current study and had received study treatment.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Bernard Coulie, MD PhD
Organizational Affiliation
Chief Medical Officer ActoGeniX NV
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Annegret Van der Aa, PhD
Organizational Affiliation
Project Manager ActoGeniX NV
Official's Role
Study Director
First Name & Middle Initial & Last Name & Degree
Severine Vermeire, MD PhD
Organizational Affiliation
UZ Leuven, Belgium
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Geert D'Haens, MD PhD
Organizational Affiliation
Imelda Bonheiden, Belgium
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Martine De Vos, MD PhD
Organizational Affiliation
UZ Gent, Belgium
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Tom Moreels, MD PhD
Organizational Affiliation
UZ Antwerpen, Belgium
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Daan Hommes, MD PhD
Organizational Affiliation
Leiden University Medical Center
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Erik Hertervig, MD PhD
Organizational Affiliation
Lund University Hospital, Sweden
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Curt Tysk, MD PhD
Organizational Affiliation
Orebro University Hospital, Sweden
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Robert Lofberg, MD PhD
Organizational Affiliation
Karolinska Institutet
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Pierre Paré, MD PhD
Organizational Affiliation
Hôpital St-Sacrement Quebec, Canada
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
William Barnett, MD PhD
Organizational Affiliation
LHSC - University Campus London, Canada
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Brian Bressler, MD PhD
Organizational Affiliation
GI Research Institute Vancouver, Canada
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
James Gregor, MD PhD
Organizational Affiliation
LHSC - South Street Campus London, Canada
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Hillary Steinhart, MD PhD
Organizational Affiliation
Mount Sinai Hospital, Canada
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Richmond Sy, MD PhD
Organizational Affiliation
Ottawa Hospital General Campus, Canada
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
William Depew, MD PhD
Organizational Affiliation
Hotel-Dieu Hospital Kingston, Canada
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Donald Daly, MD PhD
Organizational Affiliation
Victoria BC, Canada
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Philippe Vergauwe, MD PhD
Organizational Affiliation
AZ Groeninge Campus St.-Niklaas Kortrijk, Belgium
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Olivier Dewit, MD PhD
Organizational Affiliation
UCL St. Luc Brussels, Belgium
Official's Role
Principal Investigator
Facility Information:
Facility Name
Imelda Bonheiden
City
Bonheiden
ZIP/Postal Code
B-2820
Country
Belgium
Facility Name
UCL St. Luc
City
Brussels
Country
Belgium
Facility Name
UZ Antwerpen
City
Edegem
ZIP/Postal Code
B-2650
Country
Belgium
Facility Name
UZ Gent
City
Ghent
ZIP/Postal Code
B-9000
Country
Belgium
Facility Name
AZ Groeninge Campus St.-Niklaas
City
Kortrijk
Country
Belgium
Facility Name
UZ Leuven
City
Leuven
ZIP/Postal Code
B-3000
Country
Belgium
Facility Name
GI Research Institute
City
Vancouver
State/Province
British Columbia
ZIP/Postal Code
V6Z 2K5
Country
Canada
Facility Name
The office of Dr. Donald Daly
City
Victoria
State/Province
British Columbia
Country
Canada
Facility Name
Hotel Dieu Hospital
City
Kingston
State/Province
Ontario
Country
Canada
Facility Name
LHSC - South Street Campus
City
London
State/Province
Ontario
ZIP/Postal Code
N6A 4G5
Country
Canada
Facility Name
LHSC - University Campus
City
London
State/Province
Ontario
ZIP/Postal Code
N6A 5A5
Country
Canada
Facility Name
Ottawa Hospital General Campus
City
Ottawa
State/Province
Ontario
Country
Canada
Facility Name
Mount Sinai Hospital
City
Toronto
State/Province
Ontario
Country
Canada
Facility Name
Hôpital St-Sacrement
City
Quebec
ZIP/Postal Code
G1S 4L8
Country
Canada
Facility Name
Leiden University Medical Center
City
Leiden
ZIP/Postal Code
2333 ZA
Country
Netherlands
Facility Name
Lund University Hospital
City
Lund
ZIP/Postal Code
SE-221 85
Country
Sweden
Facility Name
Orebro University Hospital
City
Orebro
ZIP/Postal Code
SE-701 85
Country
Sweden
Facility Name
Sophiahemmet
City
Stockholm
ZIP/Postal Code
SE- 114 86
Country
Sweden

12. IPD Sharing Statement

Citations:
PubMed Identifier
16716759
Citation
Braat H, Rottiers P, Hommes DW, Huyghebaert N, Remaut E, Remon JP, van Deventer SJ, Neirynck S, Peppelenbosch MP, Steidler L. A phase I trial with transgenic bacteria expressing interleukin-10 in Crohn's disease. Clin Gastroenterol Hepatol. 2006 Jun;4(6):754-9. doi: 10.1016/j.cgh.2006.03.028. Epub 2006 May 22.
Results Reference
background
PubMed Identifier
25185797
Citation
Robert S, Steidler L. Recombinant Lactococcus lactis can make the difference in antigen-specific immune tolerance induction, the Type 1 Diabetes case. Microb Cell Fact. 2014 Aug 29;13 Suppl 1(Suppl 1):S11. doi: 10.1186/1475-2859-13-S1-S11. Epub 2014 Aug 29.
Results Reference
derived

Learn more about this trial

A Phase 2a Study to Evaluate the Safety, Tolerability, Pharmacodynamics and Efficacy of AG011 in Ulcerative Colitis

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