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Study Assessing Safety and Therapeutic Activity of AFFITOPE® PD01A and PD03A in Patients With Early MSA (AFF009)

Primary Purpose

Multiple System Atrophy, Neurodegenerative Diseases

Status
Completed
Phase
Phase 1
Locations
France
Study Type
Interventional
Intervention
AFFITOPE® PD01A + Adjuvant
AFFITOPE® PD03A + Adjuvant
Adjuvant without active component
Sponsored by
Affiris AG
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Multiple System Atrophy

Eligibility Criteria

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

Inclusion Criteria:

  • Possible or probably MSA diagnosis (MSA-P or MSA-C) according to Gilman 2008 consensus criteria
  • Onset of MSA symptoms less than 4 years
  • Participants with an anticipated survival of at least 3 years in the opinion of the PI
  • Written informed consent obtained prior to study entry
  • MSA patient > 30 and < 75 years of age at time of study entry
  • Female patients of childbearing potential using a medically accepted contraceptive method
  • Stable medication for MSA symptoms (Levodopa, Dopamine agonists, Midodrine, Fludrocortisone, monoamine oxidase-B and Catechol-O-methyltransferase inhibitors; Antidepressants, Laxatives, NSAIDs or paracetamol as basic medication for pain in the musculoskeletal system)

Exclusion Criteria:

  • Pregnant or lactating women
  • Sexually active women of childbearing potential not using a medically accepted birth control method
  • Patients with dementia (MOCA at Screening < 21)
  • Speech impairment as assessed by a score of ≥ 3 on UMSARS question 1
  • Swallowing impairment as assessed by a score of ≥ 3 on UMSARS question 2
  • Impairment in ambulation as assessed by a score of ≥ 3 on UMSARS question 7
  • History or evidence of any other central nervous system disorder like stroke, angioma and other relevant neurological diseases
  • History of malignancy other than skin cancer during the last 5 years (if considered to be cured, patient might be included)
  • Active or passive vaccination 4 weeks before the first vaccination on Day 0 and during the main study period ending on Day 280. Emergency vaccinations are acceptable
  • Use of any other investigational or non-registered drug or vaccine in addition to the study vaccine during the entire study period
  • Subjects participating or have participated in another interventional clinical trial within 60 days prior to baseline
  • Blood donation within 4 weeks prior to first vaccination.
  • History of autoimmune diseases, severe hypersensitivity reactions and anaphylaxis, allergic bronchial asthma and severe allergic rhinoconjunctivitis
  • Known hypersensitivity or allergic reaction to one of the components of the vaccine
  • A family history of congenital or hereditary immunodeficiency
  • Administration of chronic (defined as more than 14 days) immunosuppressant or other immune-modifying drugs within six months before first vaccination and during the entire study period. For corticosteroids like prednisone or equivalent ≥ 0.05 mg/kg/day. Topical and inhaled steroids are allowed
  • Intake of non steroidal anti-inflammatory drugs (NSAIDs) or paracetamol more than the basic medication for pain in the musculoskeletal system within three days prior to a vaccination with AFFITOPE® PD01A or AFFITOPE® PD03A or Placebo
  • If a patient shows an acute febrile infection (≥ 37.8° Celsius) on the day of vaccination, administration of Investigational Medicinal Product (IMP) should be postponed until resolution of the infection
  • Infection with the human immunodeficiency virus (HIV, a negative test result within 30 days before screening is acceptable), Hepatitis B (HBsAg) or Hepatitis C
  • Significant systemic illness (e.g. chronic renal failure, chronic liver disease, poorly controlled diabetes, poorly controlled congestive heart failure and/or other deficiencies), if considered relevant by the investigator
  • Venous status rendering it impossible to place an i.v. access
  • Contraindications for MRI and lumbar puncture
  • Not able to understand and comply with protocol requirements, instructions, protocol-stated restrictions
  • Unwilling to provide informed consent. Exceptions for patients who are physically not able to provide written informed consent (e.g. legal representative, consent via voce with witness)

Sites / Locations

  • University Hospital Bordeaux (Pellegrin Hospital)
  • University Hospital Toulouse

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Placebo Comparator

Arm Label

AFFITOPE® PD01A + Adjuvant

AFFITOPE® PD03A + Adjuvant

Adjuvant without active component

Arm Description

4 injections of 75µg AFFITOPE® PD01A/ adjuvanted, once every 4 weeks 1 boost immunization 36 weeks after first injection

4 injections of 75µg AFFITOPE® PD03A/ adjuvanted, once every 4 weeks 1 boost immunization 36 weeks after first injection

4 injections of Placebo once every 4 weeks 1 administration 36 weeks after first injection

Outcomes

Primary Outcome Measures

Number of patients who withdraw due to Adverse Events (AEs)
Occurrence of Adverse Events and Serious Adverse Events
Evaluation of Adverse Events and Serious Adverse Events in regards to autoimmune reactions
Physical Examination
New findings or change in pre-existing findings assessed in physical examinations over time (study period)
Vital signs
Change in vital signs. The Evaluation includes the changes in blood pressure, heart rate, respiratory rate and Body temperature over time (measured at each visit).
Safety related evaluation of MRI results of patients' brain after visit 5 and visit 8 compared to baseline
Safety measures will e.g. include the occurrence of inflammatory reactions (meningoencephalitis), new/changed hemorrhages and lacunar infarcts.
Clinical significance/ changes in laboratory parameters over time (study period)
Laboratory assessment includes hematology, biochemistry, coagulation, serology and urinanalysis
Body mass
Change of Body mass over time (study period)
Neurological Examination
New findings or change in pre-existing findings assessed in neurological examinations over time (study period)

Secondary Outcome Measures

Immunological activity of AFFITOPE® vaccines PD01A and PD03A.
Titer of vaccination induced antibodies directed towards vaccine components, alpha- and beta synuclein
Change in motor symptoms at Visit 5 and Visit 8 compared to baseline
Change in Motor symptoms: UMSARS II (Unified Multiple System Atrophy Rating Scale), CGI (Clinical Global Impression Improvement scale)
Change in non-motor symptoms at Visit 5 and Visit 8 compared to baseline
Change in non-motor symptoms: UMSARS I and IV, GDS (Geriatric Depression Scale), COMPASS 31 (Composite Autonomic Symptom Score), MSA-QoL (MSA- Quality of life scale), MOCA (Montreal cognitive assessment), autonomic testing of cardiovascular function

Full Information

First Posted
September 4, 2014
Last Updated
June 2, 2017
Sponsor
Affiris AG
Collaborators
University Hospital, Bordeaux, Institut National de la Santé Et de la Recherche Médicale, France, Forschungszentrum Juelich, University Hospital, Toulouse
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1. Study Identification

Unique Protocol Identification Number
NCT02270489
Brief Title
Study Assessing Safety and Therapeutic Activity of AFFITOPE® PD01A and PD03A in Patients With Early MSA
Acronym
AFF009
Official Title
A Randomized, Placebo-controlled, Parallel Group, Patient-blind, Phase I Study Assessing the Safety and Exploring the Immunogenicity/Therapeutic Activity of AFFITOPE® PD01A and PD03A in Patients With Early Multiple System Atrophy
Study Type
Interventional

2. Study Status

Record Verification Date
June 2017
Overall Recruitment Status
Completed
Study Start Date
December 11, 2014 (Actual)
Primary Completion Date
April 18, 2017 (Actual)
Study Completion Date
April 18, 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Affiris AG
Collaborators
University Hospital, Bordeaux, Institut National de la Santé Et de la Recherche Médicale, France, Forschungszentrum Juelich, University Hospital, Toulouse

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a randomized controlled parallel Group phase I study to investigate the safety and immunological/ therapeutic activity of two new vaccines, AFFITOPE® PD01A and AFFITOPE® PD03A, given to patients with early Multiple System Atrophy (MSA). In total 30 patients are planned to be enrolled in the study: 12 patients in each treatment arm who will receive either 75µg AFFITOPE® PD01A (with adjuvant) or 75µg AFFITOPE® PD03A (with adjuvant) and 6 patients in the control group who will receive the reference substance (Placebo). Over a study duration of 52 weeks, the study participants will receive 4 injections as basic immunization in a 4-weekly interval and 1 boost immunization 36 weeks after the first injection. Male and female patients aged 30 to 75 years can participate in the trial. 2 study sites in France (Bordeaux and Toulouse) will be involved. AFF009 is part of the project SYMPATH funded by the European Commission (FP7-HEALTH-2013-INNOVATION-1 project; N° HEALTH-F4-2013-602999).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Multiple System Atrophy, Neurodegenerative Diseases

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
Participant
Allocation
Randomized
Enrollment
30 (Actual)

8. Arms, Groups, and Interventions

Arm Title
AFFITOPE® PD01A + Adjuvant
Arm Type
Experimental
Arm Description
4 injections of 75µg AFFITOPE® PD01A/ adjuvanted, once every 4 weeks 1 boost immunization 36 weeks after first injection
Arm Title
AFFITOPE® PD03A + Adjuvant
Arm Type
Experimental
Arm Description
4 injections of 75µg AFFITOPE® PD03A/ adjuvanted, once every 4 weeks 1 boost immunization 36 weeks after first injection
Arm Title
Adjuvant without active component
Arm Type
Placebo Comparator
Arm Description
4 injections of Placebo once every 4 weeks 1 administration 36 weeks after first injection
Intervention Type
Biological
Intervention Name(s)
AFFITOPE® PD01A + Adjuvant
Intervention Description
s.c. injection
Intervention Type
Biological
Intervention Name(s)
AFFITOPE® PD03A + Adjuvant
Intervention Description
s.c. injection
Intervention Type
Biological
Intervention Name(s)
Adjuvant without active component
Intervention Description
s.c. injection
Primary Outcome Measure Information:
Title
Number of patients who withdraw due to Adverse Events (AEs)
Time Frame
12 months
Title
Occurrence of Adverse Events and Serious Adverse Events
Description
Evaluation of Adverse Events and Serious Adverse Events in regards to autoimmune reactions
Time Frame
12 months
Title
Physical Examination
Description
New findings or change in pre-existing findings assessed in physical examinations over time (study period)
Time Frame
12 months
Title
Vital signs
Description
Change in vital signs. The Evaluation includes the changes in blood pressure, heart rate, respiratory rate and Body temperature over time (measured at each visit).
Time Frame
12 months
Title
Safety related evaluation of MRI results of patients' brain after visit 5 and visit 8 compared to baseline
Description
Safety measures will e.g. include the occurrence of inflammatory reactions (meningoencephalitis), new/changed hemorrhages and lacunar infarcts.
Time Frame
12 months
Title
Clinical significance/ changes in laboratory parameters over time (study period)
Description
Laboratory assessment includes hematology, biochemistry, coagulation, serology and urinanalysis
Time Frame
12 months
Title
Body mass
Description
Change of Body mass over time (study period)
Time Frame
12 months
Title
Neurological Examination
Description
New findings or change in pre-existing findings assessed in neurological examinations over time (study period)
Time Frame
12 months
Secondary Outcome Measure Information:
Title
Immunological activity of AFFITOPE® vaccines PD01A and PD03A.
Description
Titer of vaccination induced antibodies directed towards vaccine components, alpha- and beta synuclein
Time Frame
12 months
Title
Change in motor symptoms at Visit 5 and Visit 8 compared to baseline
Description
Change in Motor symptoms: UMSARS II (Unified Multiple System Atrophy Rating Scale), CGI (Clinical Global Impression Improvement scale)
Time Frame
12 months
Title
Change in non-motor symptoms at Visit 5 and Visit 8 compared to baseline
Description
Change in non-motor symptoms: UMSARS I and IV, GDS (Geriatric Depression Scale), COMPASS 31 (Composite Autonomic Symptom Score), MSA-QoL (MSA- Quality of life scale), MOCA (Montreal cognitive assessment), autonomic testing of cardiovascular function
Time Frame
12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
30 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Possible or probably MSA diagnosis (MSA-P or MSA-C) according to Gilman 2008 consensus criteria Onset of MSA symptoms less than 4 years Participants with an anticipated survival of at least 3 years in the opinion of the PI Written informed consent obtained prior to study entry MSA patient > 30 and < 75 years of age at time of study entry Female patients of childbearing potential using a medically accepted contraceptive method Stable medication for MSA symptoms (Levodopa, Dopamine agonists, Midodrine, Fludrocortisone, monoamine oxidase-B and Catechol-O-methyltransferase inhibitors; Antidepressants, Laxatives, NSAIDs or paracetamol as basic medication for pain in the musculoskeletal system) Exclusion Criteria: Pregnant or lactating women Sexually active women of childbearing potential not using a medically accepted birth control method Patients with dementia (MOCA at Screening < 21) Speech impairment as assessed by a score of ≥ 3 on UMSARS question 1 Swallowing impairment as assessed by a score of ≥ 3 on UMSARS question 2 Impairment in ambulation as assessed by a score of ≥ 3 on UMSARS question 7 History or evidence of any other central nervous system disorder like stroke, angioma and other relevant neurological diseases History of malignancy other than skin cancer during the last 5 years (if considered to be cured, patient might be included) Active or passive vaccination 4 weeks before the first vaccination on Day 0 and during the main study period ending on Day 280. Emergency vaccinations are acceptable Use of any other investigational or non-registered drug or vaccine in addition to the study vaccine during the entire study period Subjects participating or have participated in another interventional clinical trial within 60 days prior to baseline Blood donation within 4 weeks prior to first vaccination. History of autoimmune diseases, severe hypersensitivity reactions and anaphylaxis, allergic bronchial asthma and severe allergic rhinoconjunctivitis Known hypersensitivity or allergic reaction to one of the components of the vaccine A family history of congenital or hereditary immunodeficiency Administration of chronic (defined as more than 14 days) immunosuppressant or other immune-modifying drugs within six months before first vaccination and during the entire study period. For corticosteroids like prednisone or equivalent ≥ 0.05 mg/kg/day. Topical and inhaled steroids are allowed Intake of non steroidal anti-inflammatory drugs (NSAIDs) or paracetamol more than the basic medication for pain in the musculoskeletal system within three days prior to a vaccination with AFFITOPE® PD01A or AFFITOPE® PD03A or Placebo If a patient shows an acute febrile infection (≥ 37.8° Celsius) on the day of vaccination, administration of Investigational Medicinal Product (IMP) should be postponed until resolution of the infection Infection with the human immunodeficiency virus (HIV, a negative test result within 30 days before screening is acceptable), Hepatitis B (HBsAg) or Hepatitis C Significant systemic illness (e.g. chronic renal failure, chronic liver disease, poorly controlled diabetes, poorly controlled congestive heart failure and/or other deficiencies), if considered relevant by the investigator Venous status rendering it impossible to place an i.v. access Contraindications for MRI and lumbar puncture Not able to understand and comply with protocol requirements, instructions, protocol-stated restrictions Unwilling to provide informed consent. Exceptions for patients who are physically not able to provide written informed consent (e.g. legal representative, consent via voce with witness)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Wassilios Meissner, MD, PhD
Organizational Affiliation
University Hospital Bordeaux (Pellegrin Hospital), Bordeaux 33076, France
Official's Role
Principal Investigator
Facility Information:
Facility Name
University Hospital Bordeaux (Pellegrin Hospital)
City
Bordeaux Cedex
ZIP/Postal Code
33076
Country
France
Facility Name
University Hospital Toulouse
City
Toulouse Cedex 9
ZIP/Postal Code
31059
Country
France

12. IPD Sharing Statement

Citations:
PubMed Identifier
32882100
Citation
Meissner WG, Traon AP, Foubert-Samier A, Galabova G, Galitzky M, Kutzelnigg A, Laurens B, Luhrs P, Medori R, Peran P, Sabatini U, Vergnet S, Volc D, Poewe W, Schneeberger A, Staffler G, Rascol O; AFF009 Study Investigators. A Phase 1 Randomized Trial of Specific Active alpha-Synuclein Immunotherapies PD01A and PD03A in Multiple System Atrophy. Mov Disord. 2020 Nov;35(11):1957-1965. doi: 10.1002/mds.28218. Epub 2020 Sep 3.
Results Reference
derived

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Study Assessing Safety and Therapeutic Activity of AFFITOPE® PD01A and PD03A in Patients With Early MSA

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