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Cold Contact Urticaria Treatment With Rilonacept (Cures)

Primary Purpose

Cold Contact Urticaria

Status
Completed
Phase
Phase 2
Locations
Germany
Study Type
Interventional
Intervention
Rilonacept
Placebo
Sponsored by
Charite University, Berlin, Germany
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Cold Contact Urticaria

Eligibility Criteria

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

Inclusion Criteria:

  • Adult ( > 18 years of age)
  • Outpatients with CCU for more than six weeks. Urticaria symptoms must comprise wheal and itch and be resistant to conventional antihistamine treatment in standard doses
  • Patients with a positive cold stimulation test at 4°C (assessed by TEMPtest 3.0)
  • Informed consent signed and dated. Able to read, understand and willing to sign the informed consent form
  • Able to read, understand and complete study-related questionnaires
  • Willing, committed and able to return for all clinic visits and complete all study-related procedures, including willingness to self-administer SC injections or to have SC injections administered by a qualified person
  • In women, negative pregnancy test
  • Reliable method of contraception for both women of childbearing potential as well as men, during the course of the study. A highly effective method of birth control is defined as those which result in a low failure rate (i.e. less than 1% per year) when used consistently and correctly such as implants, injectables, combined oral contraceptives, some IUDs, sexual abstinence or vasectomised partner.
  • Subjects are considered eligible according to the following tuberculosis (TB) screening criteria:
  • No history of latent or active TB prior to screening
  • No signs or symptoms suggestive of active TB
  • No recent close contacts with a person with active TB
  • A negative QuantiFERON-TB test on day -14 (screening visit).

Exclusion Criteria:

  • Treatment with a live (attenuated) virus vaccine during the month prior to day 0 (Randomization).
  • A history of serious chronic or active infection(s) eg. listeriosis within six weeks prior to the screening visit.
  • Evidence of acute or latent Tuberculosis as defined by the local guidelines/local medical practice
  • A history of acute tuberculosis despite the proper treatment.
  • Significant concomitant illness such as, but not limited to, cardiac, renal, neurological, endocrinological, metabolic, lymphatic or hematological disease that would adversely affect the subject's participation or evaluation in this study.
  • Active systemic inflammatory condition including, but not limited to, rheumatoid arthritis, systemic lupus erythematosis, polymyalgia rheumatica, vasculitis, or myositis.
  • History of fibromyalgia or chronic fatigue syndrome.
  • Evidence of current HIV, Hepatitis B, or Hepatitis C infection by clinical or serological history.
  • History of malignancies including malignant hematological disorders other than a successfully treated non-metastatic cutaneous, basal, or squamous cell carcinoma and/or in situ cervical cancer within five years of the Screening visit.
  • Severe respiratory disease, including, but not limited to severe bronchiectasis, chronic obstructive pulmonary disease, bullous lung disease, uncontrolled asthma, or pulmonary fibrosis.
  • Presence of any of the following laboratory abnormalities at enrollment visit: creatinine >1.5 x Upper Limit of Normal (ULN), WBC <3.6 x 103/mm3; platelet count <150,000 mm3; ALT or AST >2.0 x ULN.
  • Previous ineffective treatment with IL1 inhibitor or other biologic agent.
  • Known hypersensitivity to CHO cell derived therapeutics or proteins or any components of rilonacept.
  • Any medical condition which, in the opinion of the Investigator, would interfere with participation in the study or place the subject at risk.
  • Present History of substance abuse (drug or alcohol) or any other factor (e.g., serious psychiatric condition) that could limit the subject's ability to comply with study procedures.
  • Lactating females or pregnant females.
  • Enrollment in another investigational treatment or device study or use of an investigational agent, or no completion of less than 4 weeks or 5 half-lives, whichever is longer, since end of another investigational device or drug trial.
  • Subjects for whom there is concern about compliance with the protocol procedures.
  • Subjects who are detained officially or legally to an official institute.

Sites / Locations

  • University Berlin Charité ; Dermatology
  • Universitätsmedizin

Arms of the Study

Arm 1

Arm 2

Arm Type

Placebo Comparator

Experimental

Arm Label

Placebo

Rilonacept 160mg

Arm Description

Placebo s.c every 7 days

Rilonacept s.c every 7 days

Outcomes

Primary Outcome Measures

To assess the effect of rilonacept on the clinical signs and symptoms of CCU
Change in symptom development (critical temperature thresholds (CTT) in CCU patients from baseline to day 42 in the rilonacept group as compared to the placebo group

Secondary Outcome Measures

To assess the safety of rilonacept in subjects with CCU
This includes physical examination, routine safety laboratory assessments, vital signs and adverse event reporting

Full Information

First Posted
June 13, 2014
Last Updated
July 16, 2018
Sponsor
Charite University, Berlin, Germany
Collaborators
Regeneron Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT02171416
Brief Title
Cold Contact Urticaria Treatment With Rilonacept
Acronym
Cures
Official Title
A Single-center, Double-blind Placebo-controlled Parallel Group Phase II Study of the Efficacy and Safety of Rilonacept in Subjects With Cold Contact Urticaria (CCU)
Study Type
Interventional

2. Study Status

Record Verification Date
March 2018
Overall Recruitment Status
Completed
Study Start Date
January 2015 (undefined)
Primary Completion Date
February 28, 2018 (Actual)
Study Completion Date
May 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Charite University, Berlin, Germany
Collaborators
Regeneron Pharmaceuticals

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Cold contact urticaria (CCU) is a frequent form of physical urticaria that is characterized by the development of wheal and flare type skin reactions due to the release of histamine and other proinflammatory mast cell mediators following exposure of the skin to cold. Typically, symptoms occur within minutes after cold contact, including exposure to cold air, liquids or objects and are limited to cold exposed skin areas. The investigators postulate that there is an overlap between acquired cold urticaria and cold-induced autoinflammatory syndromes, and that cold urticaria patients unresponsive to antihistamines will benefit from IL-1 targeting treatment strategies. This study will evaluate the efficacy and safety of the IL-1 transfusion protein rilonacept in patients with cold contact urticaria who could not be successfully treated with first-line medication such as antihistamines. This is a double-blind placebo-controlled parallel group phase II study of the efficacy and safety of rilonacept in subjects with CCU. A total of 20 patients will be included by the Urticaria specialty clinics of ACC. The total duration of the study course for each patient is 14 weeks and is divided in: Screening period (2 weeks, days -14-0) Placebo-controlled double-blind phase (Part A, 6 weeks, days 0-42) Open label phase (Part B, 6 weeks, days 42-84) All eligible patients will be randomized (1:1 randomization) to one of two groups: 1) Rilonacept 160mg/week or 2) Placebo, and will receive the respective dose subcutaneously. Following the placebo-controlled double-blind phase patients will enter the open-label phase and receive rilonacept open-label treatment (160mg or 320mg depending on treatment response during part A).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cold Contact Urticaria

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
20 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo s.c every 7 days
Arm Title
Rilonacept 160mg
Arm Type
Experimental
Arm Description
Rilonacept s.c every 7 days
Intervention Type
Drug
Intervention Name(s)
Rilonacept
Other Intervention Name(s)
Arcalyst
Intervention Type
Drug
Intervention Name(s)
Placebo
Primary Outcome Measure Information:
Title
To assess the effect of rilonacept on the clinical signs and symptoms of CCU
Description
Change in symptom development (critical temperature thresholds (CTT) in CCU patients from baseline to day 42 in the rilonacept group as compared to the placebo group
Time Frame
6 weeks
Secondary Outcome Measure Information:
Title
To assess the safety of rilonacept in subjects with CCU
Description
This includes physical examination, routine safety laboratory assessments, vital signs and adverse event reporting
Time Frame
6 weeks
Other Pre-specified Outcome Measures:
Title
Change in the patient's quality of life
Description
Assessed by the Dermatology Life Quality Index (DLQI) from baseline to day 42 in the rilonacept group as compared to the placebo group and from baseline to the open-label treatment with rilonacept
Time Frame
6 weeks
Title
Differences in mast cell mediator release
Description
Measured in the blood of CCU patients during the challenge with cold water at day 42 in the rilonacept group as compared to the placebo group and during the open-label treatment in the rilonacept 160 mg group as compared to the 320 mg group
Time Frame
6 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Adult ( > 18 years of age) Outpatients with CCU for more than six weeks. Urticaria symptoms must comprise wheal and itch and be resistant to conventional antihistamine treatment in standard doses Patients with a positive cold stimulation test at 4°C (assessed by TEMPtest 3.0) Informed consent signed and dated. Able to read, understand and willing to sign the informed consent form Able to read, understand and complete study-related questionnaires Willing, committed and able to return for all clinic visits and complete all study-related procedures, including willingness to self-administer SC injections or to have SC injections administered by a qualified person In women, negative pregnancy test Reliable method of contraception for both women of childbearing potential as well as men, during the course of the study. A highly effective method of birth control is defined as those which result in a low failure rate (i.e. less than 1% per year) when used consistently and correctly such as implants, injectables, combined oral contraceptives, some IUDs, sexual abstinence or vasectomised partner. Subjects are considered eligible according to the following tuberculosis (TB) screening criteria: No history of latent or active TB prior to screening No signs or symptoms suggestive of active TB No recent close contacts with a person with active TB A negative QuantiFERON-TB test on day -14 (screening visit). Exclusion Criteria: Treatment with a live (attenuated) virus vaccine during the month prior to day 0 (Randomization). A history of serious chronic or active infection(s) eg. listeriosis within six weeks prior to the screening visit. Evidence of acute or latent Tuberculosis as defined by the local guidelines/local medical practice A history of acute tuberculosis despite the proper treatment. Significant concomitant illness such as, but not limited to, cardiac, renal, neurological, endocrinological, metabolic, lymphatic or hematological disease that would adversely affect the subject's participation or evaluation in this study. Active systemic inflammatory condition including, but not limited to, rheumatoid arthritis, systemic lupus erythematosis, polymyalgia rheumatica, vasculitis, or myositis. History of fibromyalgia or chronic fatigue syndrome. Evidence of current HIV, Hepatitis B, or Hepatitis C infection by clinical or serological history. History of malignancies including malignant hematological disorders other than a successfully treated non-metastatic cutaneous, basal, or squamous cell carcinoma and/or in situ cervical cancer within five years of the Screening visit. Severe respiratory disease, including, but not limited to severe bronchiectasis, chronic obstructive pulmonary disease, bullous lung disease, uncontrolled asthma, or pulmonary fibrosis. Presence of any of the following laboratory abnormalities at enrollment visit: creatinine >1.5 x Upper Limit of Normal (ULN), WBC <3.6 x 103/mm3; platelet count <150,000 mm3; ALT or AST >2.0 x ULN. Previous ineffective treatment with IL1 inhibitor or other biologic agent. Known hypersensitivity to CHO cell derived therapeutics or proteins or any components of rilonacept. Any medical condition which, in the opinion of the Investigator, would interfere with participation in the study or place the subject at risk. Present History of substance abuse (drug or alcohol) or any other factor (e.g., serious psychiatric condition) that could limit the subject's ability to comply with study procedures. Lactating females or pregnant females. Enrollment in another investigational treatment or device study or use of an investigational agent, or no completion of less than 4 weeks or 5 half-lives, whichever is longer, since end of another investigational device or drug trial. Subjects for whom there is concern about compliance with the protocol procedures. Subjects who are detained officially or legally to an official institute.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Karoline Krause, MD
Organizational Affiliation
Charite University, Berlin, Germany
Official's Role
Principal Investigator
Facility Information:
Facility Name
University Berlin Charité ; Dermatology
City
Berlin
ZIP/Postal Code
10117
Country
Germany
Facility Name
Universitätsmedizin
City
Mainz
ZIP/Postal Code
55131
Country
Germany

12. IPD Sharing Statement

Plan to Share IPD
Undecided

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Cold Contact Urticaria Treatment With Rilonacept

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