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Bovine Intestinal Alkaline Phosphatase (bIAP) Modulating Rheumatoid Arthritis (ALS-003-2008)

Primary Purpose

Acute Rheumatoid Arthritis

Status
Completed
Phase
Phase 1
Locations
United Kingdom
Study Type
Interventional
Intervention
s.c. injections of bovine intestinal Alkaline Phosphatase
Sponsored by
Alloksys Life Sciences B.V.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acute Rheumatoid Arthritis focused on measuring acute rheumatoid arthritis

Eligibility Criteria

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

Inclusion Criteria:

1. Male or non-pregnant, non-lactating female patients of any race with an age >18 years. Woman of child-bearing potential must be on regular contraceptives throughout the trial (Pregnancy tests).

1A: RA according to the 1987 revised ARA criteria (Arnett 1987) with an active disease with DAS28>3.2 despite the prior or concurrent use of DMARDs.

2. Patients may be on no active therapy or may be on continuous DMARD therapy including Methotrexate, Sulphasalazine, Leflunomide, Hydroxychloroquine, Myocrisin alone or in combination, or on NSAID treatment, or on steroid (prednisolone not more than 10mg/day).

3. Patients must have a measurable acute phase response: CRP (> 10mg/dl), ESR > 25. (to be measured on routine lab range CRP/ ESR/AP/ standard biochemistry)

4. Patients eligible for treatment with biological TNFα blockers and who are awaiting the administration of such treatment may enroll in the laboratory and safety protocols Data for Clinical Phase observations will be collected but will be handled as last observation carried forward for the final records prior to the administration of TNF blocking agent, should that occur within the 3-month Clinical Phase. The administration of TNFα blockers will not be delayed for the protocol.

5. Patients who have given written informed consent prior to participation in the trial and who undertake to comply with the protocol.

Exclusion Criteria:

  1. Patients who are unwilling or unable to be fully evaluated for follow-up.
  2. Patients who have an active infection or who are suspected of having systemic infection and or patients that are treated with antibiotics.
  3. Patients whose screening blood do not reflect a sufficient cytokine or acute phase response.
  4. Patients who have evidence of significant hepatic disease, including history of clinical signs or laboratory values of total bilirubin > 34.2 umol/L (> 2.0 mg/dL), ALT (>120) or AST (>135) corresponding to > 3X upper limit of normal.
  5. Alkaline phosphatase levels must be less 145 IU/L (routine clinical method)
  6. Patients who received investigational drugs in the 30 days prior to study drug administration, or are currently participating in a study during which the administration of investigational drugs within one month is anticipated.
  7. Patients who have renal insufficiency (history of creatinine >177umol/L or >2.0 mg/dL) or chronic renal failure requiring dialysis.
  8. Patients with severe neurological deficits (see Appendix I).
  9. Patients who have a recent history of drug substance or alcohol abuse.
  10. Patients with a diagnosis of idiopathic thrombocytopenia.
  11. Patients with a history of cancer who have received chemotherapy or radiation therapy within the past 3 months. Patients receiving only adjuvant hormonal therapy are not excluded. If the cancer has not resolved completely, the patient should not be enrolled without permission of Alloksys.
  12. Patients receiving oral glucocorticoids >10mg /day or any IV, IM or Intra articular dosing within 30 days of commencing the protocol.
  13. Patients who are vegetarians or veganists or those patients that may be expected not to be tolerant to bovine proteins, or not to wish exposure to bovine proteins for personal reasons.
  14. Patients who are, in the opinion of the Investigator or the Sponsor, unsuitable for the study.

Sites / Locations

  • Maidstone Hospital, Dept. Rheumatology

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

bIAP treatment

Arm Description

Outcomes

Primary Outcome Measures

blood level of the pro-inflammatory cytokines: TNFα and IL6
The anticipated effects of bIAP will be short lived, within 4 days. However, in order to capture durable clinical responses or any late adverse effects, patients will be followed through 3 months at weeks 2, 4, 8 and 12 incorporating trial observations with routine monthly care to reduce disruption to patients.

Secondary Outcome Measures

RA clinical status expressed as Daily Activity Score (DAS-28)
van der Heijde DM, van 't Hof MA, van Riel PL, Theunisse LA, Lubberts EW, van Leeuwen MA, van Rijswijk MH, van de Putte LB. Judging disease activity in clinical practice in rheumatoid arthritis: first step in the development of a disease activity score. Ann Rheum Dis. 1990 Nov;49(11):916-920

Full Information

First Posted
August 11, 2011
Last Updated
March 9, 2015
Sponsor
Alloksys Life Sciences B.V.
Collaborators
Aix Scientifics
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1. Study Identification

Unique Protocol Identification Number
NCT01416493
Brief Title
Bovine Intestinal Alkaline Phosphatase (bIAP) Modulating Rheumatoid Arthritis
Acronym
ALS-003-2008
Official Title
An OPEN LABEL Phase II Safety Study of Bovine Intestinal Alkaline Phosphatase (bIAP), an Inflammation Modulating Moiety, in RA Patients
Study Type
Interventional

2. Study Status

Record Verification Date
March 2015
Overall Recruitment Status
Completed
Study Start Date
May 2011 (undefined)
Primary Completion Date
April 2013 (Actual)
Study Completion Date
April 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Alloksys Life Sciences B.V.
Collaborators
Aix Scientifics

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a proof of concept study asking if alkaline phosphatase injections can reduce acute inflammation in rheumatoid arthritis patients.
Detailed Description
This is a proof of concept study to establish the safety of subcutaneous (sc) treatment and the efficacy of alkaline phosphatase (AP) in reducing specific pro-inflammatory cytokines during and after 3 days of twice daily s.c. treatment. A total dose of 12000 Units AP will be administered by 2000 IU s.c. injection twice daily for 3 days. Subjects will be closely followed for 8 days and regular clinical observations will be made during 3 months. Close out will be 3 months after initiation of treatment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Rheumatoid Arthritis
Keywords
acute rheumatoid arthritis

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
6 (Actual)

8. Arms, Groups, and Interventions

Arm Title
bIAP treatment
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
s.c. injections of bovine intestinal Alkaline Phosphatase
Intervention Description
daily subcutaneous treatment with two injections of 2000IU bIAP for three days
Primary Outcome Measure Information:
Title
blood level of the pro-inflammatory cytokines: TNFα and IL6
Description
The anticipated effects of bIAP will be short lived, within 4 days. However, in order to capture durable clinical responses or any late adverse effects, patients will be followed through 3 months at weeks 2, 4, 8 and 12 incorporating trial observations with routine monthly care to reduce disruption to patients.
Time Frame
3 months
Secondary Outcome Measure Information:
Title
RA clinical status expressed as Daily Activity Score (DAS-28)
Description
van der Heijde DM, van 't Hof MA, van Riel PL, Theunisse LA, Lubberts EW, van Leeuwen MA, van Rijswijk MH, van de Putte LB. Judging disease activity in clinical practice in rheumatoid arthritis: first step in the development of a disease activity score. Ann Rheum Dis. 1990 Nov;49(11):916-920
Time Frame
3 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: 1. Male or non-pregnant, non-lactating female patients of any race with an age >18 years. Woman of child-bearing potential must be on regular contraceptives throughout the trial (Pregnancy tests). 1A: RA according to the 1987 revised ARA criteria (Arnett 1987) with an active disease with DAS28>3.2 despite the prior or concurrent use of DMARDs. 2. Patients may be on no active therapy or may be on continuous DMARD therapy including Methotrexate, Sulphasalazine, Leflunomide, Hydroxychloroquine, Myocrisin alone or in combination, or on NSAID treatment, or on steroid (prednisolone not more than 10mg/day). 3. Patients must have a measurable acute phase response: CRP (> 10mg/dl), ESR > 25. (to be measured on routine lab range CRP/ ESR/AP/ standard biochemistry) 4. Patients eligible for treatment with biological TNFα blockers and who are awaiting the administration of such treatment may enroll in the laboratory and safety protocols Data for Clinical Phase observations will be collected but will be handled as last observation carried forward for the final records prior to the administration of TNF blocking agent, should that occur within the 3-month Clinical Phase. The administration of TNFα blockers will not be delayed for the protocol. 5. Patients who have given written informed consent prior to participation in the trial and who undertake to comply with the protocol. Exclusion Criteria: Patients who are unwilling or unable to be fully evaluated for follow-up. Patients who have an active infection or who are suspected of having systemic infection and or patients that are treated with antibiotics. Patients whose screening blood do not reflect a sufficient cytokine or acute phase response. Patients who have evidence of significant hepatic disease, including history of clinical signs or laboratory values of total bilirubin > 34.2 umol/L (> 2.0 mg/dL), ALT (>120) or AST (>135) corresponding to > 3X upper limit of normal. Alkaline phosphatase levels must be less 145 IU/L (routine clinical method) Patients who received investigational drugs in the 30 days prior to study drug administration, or are currently participating in a study during which the administration of investigational drugs within one month is anticipated. Patients who have renal insufficiency (history of creatinine >177umol/L or >2.0 mg/dL) or chronic renal failure requiring dialysis. Patients with severe neurological deficits (see Appendix I). Patients who have a recent history of drug substance or alcohol abuse. Patients with a diagnosis of idiopathic thrombocytopenia. Patients with a history of cancer who have received chemotherapy or radiation therapy within the past 3 months. Patients receiving only adjuvant hormonal therapy are not excluded. If the cancer has not resolved completely, the patient should not be enrolled without permission of Alloksys. Patients receiving oral glucocorticoids >10mg /day or any IV, IM or Intra articular dosing within 30 days of commencing the protocol. Patients who are vegetarians or veganists or those patients that may be expected not to be tolerant to bovine proteins, or not to wish exposure to bovine proteins for personal reasons. Patients who are, in the opinion of the Investigator or the Sponsor, unsuitable for the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Anthony Hammond, MD
Organizational Affiliation
Maidstone Hospital, Dept. Rheumatology
Official's Role
Principal Investigator
Facility Information:
Facility Name
Maidstone Hospital, Dept. Rheumatology
City
Maidstone
State/Province
Kent
ZIP/Postal Code
ME16 9QQ
Country
United Kingdom

12. IPD Sharing Statement

Links:
URL
http://clinicaltrials.gov/ct2/show/NCT01144611
Description
an other running study with bovine Intestinal Alkaline Phosphatase (bIAP)

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Bovine Intestinal Alkaline Phosphatase (bIAP) Modulating Rheumatoid Arthritis

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