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Study Assessing Tolerability and Safety and Exploring the Immunogenicity and Therapeutic Activity of AFFITOPE® PD01A in PD-GBA Patients

Primary Purpose

Parkinson's Disease

Status
Withdrawn
Phase
Phase 1
Locations
Germany
Study Type
Interventional
Intervention
AFFITOPE® PD01A + 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 Parkinson's Disease focused on measuring GBA mutation

Eligibility Criteria

40 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Confirmed diagnosis of Parkinson's disease and confirmed carrier status for a heterozygous GBA mutation (PDGBA)
  • Individuals who present in Hoehn&Yahr Stages I/II/III and fulfill the United Kingdom Parkinson's Disease Society Brain Bank Criteria
  • Confirmed carrier status for a heterozygous GBA mutation (PDGBA)-The result of the MRI scan of the patient's brain has to be consistent with the diagnosis of PD
  • Written informed consent signed and dated by the patient and, preferentially, the caregiver (caregiver is not mandatory)
  • Age between 40 and 80
  • In the investigator's opinion, does not have visual or auditory impairments that would reduce the patients' ability to complete study questionnaires or be unable to receive instructions for these
  • Female patients of childbearing potential are eligible if they use a medically accepted contraceptive method
  • A potential participant treated with conventional PD therapies must be on stable doses for at least 3 months prior to Visit 1 and during the entire trial period
  • Accepted PD medications include the following: levodopa (alone or in combination with benserazide, carbidopa), catechol-O-methyltransferase (COMT) inhibitors (entacapone, tolcapone), amantadine, non-ergot dopamine agonists (pramipexol, ropinirol, rotigotine), monoamine oxidase-B (MAO-B) inhibitors (rasagiline, selegiline) and anticholinergic medication
  • A potential participant should be on stable doses of all medications he/she is taking because of consisting illnesses according to medical history (except PD therapies, these will be recorded separately) for at least 30 days prior to Visit 1 if considered relevant by the investigator
  • Able to communicate well with the investigator, to understand and comply with the requirements of the study

Exclusion Criteria:

  • Pregnant women
  • Sexually active women of childbearing potential who are not using a medically accepted birth control method
  • Participation in another clinical trial within 3 months before Visit 1
  • History of questionable compliance to visit schedule; patients not expected to complete the clinical trial
  • Presence or history of allergy to components of the vaccine if considered relevant by the investigator
  • Contraindication for MRI imaging such as metallic implants (e.g. endoprosthesis, stents, cardiac pacemakers) which are not MR compatible at 3.0 Tesla with the given MR protocol, other foreign metal bodies (e.g. bullets, metal splinters, e.g.) or claustrophobia
  • Missing agreement to be informed about incident findings and consultation of a neuroradiologist
  • Contraindication for PET, that is, pregnancy and breast feeding.
  • Ongoing participation in other interventional studies or clinical trials using radiotracers
  • Dementia according to Diagnostic and Statistical Manual (DSM) IV criteria
  • History and/or presence of autoimmune disease, if considered relevant by the investigator
  • Recent (≤3 years since last specific treatment) history of cancer (Exceptions: non-melanoma skin cancer, intraepithelial cervical neoplasia)
  • Active infectious disease (e.g., Hepatitis B, C)
  • Presence and/or history of Immunodeficiency (e.g., HIV)
  • Significant systemic illness (e.g., chronic renal failure, chronic liver disease, poorly controlled diabetes, poorly controlled congestive heart failure, other deficiencies), if considered relevant by the investigator
  • History of significant psychiatric illness such as schizophrenia, bipolar affective disorder or psychotic depression
  • Parkinson-like disease secondary to drug therapy side effects (e.g., due to exposure to medications that deplete dopamine [reserpine, tetrabenazine] or block dopamine receptors [neuroleptics, antiemetics])
  • Parkinson-plus syndromes (e.g., multiple system atrophy (MSA), progressive supranuclear palsy (PSP)), Dementia with Lewy Bodies (DLB)
  • Heredodegenerative disorders other than PDGBA, evidence for other genetic forms of PD (e.g. LRRK2, Parkin gene mutations)
  • Alcoholism or substance abuse within the past year (alcohol or drug intoxication)
  • Prior and/or current treatment with experimental immunotherapeutics including Intravenous Immunoglobulin (IVIG)
  • Prior and/or current treatment with immune modulating drugs:

    1. Interleukins, Interferons, Tumor Necrosis Factor (TNF) and analogues, colony stimulating factor compounds
    2. Ciclosporin, Tacrolimus, Sirolimus and analogues
    3. Cytostatic drugs and certain DMARD for rheumatoid arthritis (and similar autoimmune disorders) (e.g. Cyclophosphamid, Azathioprin, methotrexate, sulfasalazine, leflunomide, sodium aurothiomalate (Gold), cyclosporin) and analogues
    4. Systemic (gluco)corticoid therapy
    5. All antibody therapies (e.g., anti cluster of differentiation 3 (CD3), anti cluster of differentiation 25 (CD25) or also anti-lymphocyte globulins) that might modulate, enhance or weaken an immune response
  • Change in dose of standard treatments for PD within 3 months prior to Visit 1
  • Change in dose of previous and current medications which the patient is taking because of consisting illnesses according medical history (except PD therapies, these will be recorded separately) within the last 30 days prior to Visit 1, if clinically relevant
  • Treatment with deep brain stimulation
  • Venous status rendering it impossible to place an i.v. access

Sites / Locations

  • University Hospital Tübingen

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

AFFITOPE® PD01A + Adjuvant

Adjuvant without active component

Arm Description

3 injections of 75µg AFFITOPE® PD01A/ adjuvanted, once every 4 weeks

3 injections of Placebo once every 4 weeks

Outcomes

Primary Outcome Measures

Number of patients who withdraw due to Adverse Events (AEs) and reason for withdrawal
Occurrence of any Serious Adverse Event (SAE) possibly, probably or definitely related to the study vaccine at any time during the study
Occurrence of any Grade 3 or higher AEs possibly, probably or definitely related to the study vaccine within 4 weeks after the vaccinations
Occurrence of solicited local AEs
Injection site pain, erythema (redness), hyperthermia at injection site, itching, edema (swelling), induration [hardening], granuloma within 1 week (Day 1-7) after the vaccinations: Severity and duration
Occurrence of solicited systemic AEs
Headache, myalgia (muscle pain), fever, fatigue, nausea within 1 week (Day 1-7) after the vaccinations: Severity and duration.
Occurrence of unsolicited non-serious AEs within four weeks after the vaccinations
Severity, duration and relationship to vaccination

Secondary Outcome Measures

Immunological activity of AFFITOPE® vaccine PD01A over time (study period)
Titer of immunoglobulin G (IgG) Abs specific for the immunizing peptide (PD01A), the carrier (KLH) and the target (targeted native α-Synuclein (aSyn) epitope coupled to bovine serum albumin (BSA) (mandatory) or presented in different forms - particularly monomers, pre-fibrils and fibrils (optional)) assessed by Enzyme-Linked Immunosorbent Assay (ELlSA) (or an equivalent method)
Imaging efficacy variables at visit 6 (or EDV) compared to baseline
11C-Pittsburgh Compound B (11C-PIB), 18F-Fluorodeoxyglucose-Positron Emission Tomography (18F-FDG-PET), resting-state functional magnetic resonance imaging (fMRI), diffusion-weighted/tensor magnetic resonance imaging (MRI), Magnetic Resonance-Spectroscopy
Biomarker data at visit 6 (or EDV) compared to baseline
β-Glucocerebrosidase (GCase) enzyme activity

Full Information

First Posted
April 26, 2016
Last Updated
August 4, 2016
Sponsor
Affiris AG
Collaborators
University Hospital Tuebingen
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1. Study Identification

Unique Protocol Identification Number
NCT02758730
Brief Title
Study Assessing Tolerability and Safety and Exploring the Immunogenicity and Therapeutic Activity of AFFITOPE® PD01A in PD-GBA Patients
Official Title
A Randomized, Placebo-controlled, Parallel Group, Patient-blind, Single-center Phase I Pilot Study Assessing Tolerability and Safety and Exploring the Immunogenicity and Therapeutic Activity of AFFITOPE® PD01A, a New Vaccine Against Alpha-synuclein, in Patients With PD-GBA
Study Type
Interventional

2. Study Status

Record Verification Date
August 2016
Overall Recruitment Status
Withdrawn
Study Start Date
undefined (undefined)
Primary Completion Date
October 2017 (Anticipated)
Study Completion Date
undefined (undefined)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Affiris AG
Collaborators
University Hospital Tuebingen

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a randomized, placebo-controlled, parallel group, patient-blind, single-center phase I clinical trial of repeated once every 4 weeks administration by subcutaneous injection of AFFITOPE® PD01A, adsorbed to aluminium oxide in 30 patients with PD-GBA over a treatment period of 8 weeks. Patients will be randomized in a 2:1 ratio to two different treatment groups: A) 75 µg AFFITOPE® PD01A, adsorbed to aluminium oxide and B) placebo (= 1 mg aluminium oxide). Over a study duration of 52 weeks, each patient will receive 3 injections of AFFITOPE® PD01A or placebo during the participation in the clinical trial. Patients will either receive 75 µg AFFITOPE® PD01A adsorbed to 1 mg aluminium oxide or placebo (=1mg aluminium oxide). The treatment group consists of 20 PDGBA patients, the placebo group of 10 PDGBA patients. Male and female patients aged 40 to 80 years can participate in the trial. AFF010 is part of the project MULTISYN funded by the European Commission (FP7-HEALTH-2013-INNOVATION-1 project; N° HEALTH-F4-2013-602646).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Parkinson's Disease
Keywords
GBA mutation

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
AFFITOPE® PD01A + Adjuvant
Arm Type
Experimental
Arm Description
3 injections of 75µg AFFITOPE® PD01A/ adjuvanted, once every 4 weeks
Arm Title
Adjuvant without active component
Arm Type
Placebo Comparator
Arm Description
3 injections of Placebo once every 4 weeks
Intervention Type
Biological
Intervention Name(s)
AFFITOPE® PD01A + 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) and reason for withdrawal
Time Frame
52 weeks
Title
Occurrence of any Serious Adverse Event (SAE) possibly, probably or definitely related to the study vaccine at any time during the study
Time Frame
52 weeks
Title
Occurrence of any Grade 3 or higher AEs possibly, probably or definitely related to the study vaccine within 4 weeks after the vaccinations
Time Frame
12 weeks (week 0 to 12)
Title
Occurrence of solicited local AEs
Description
Injection site pain, erythema (redness), hyperthermia at injection site, itching, edema (swelling), induration [hardening], granuloma within 1 week (Day 1-7) after the vaccinations: Severity and duration
Time Frame
up to 52 weeks
Title
Occurrence of solicited systemic AEs
Description
Headache, myalgia (muscle pain), fever, fatigue, nausea within 1 week (Day 1-7) after the vaccinations: Severity and duration.
Time Frame
up to 52 weeks
Title
Occurrence of unsolicited non-serious AEs within four weeks after the vaccinations
Description
Severity, duration and relationship to vaccination
Time Frame
12 weeks (week 0 to 12)
Secondary Outcome Measure Information:
Title
Immunological activity of AFFITOPE® vaccine PD01A over time (study period)
Description
Titer of immunoglobulin G (IgG) Abs specific for the immunizing peptide (PD01A), the carrier (KLH) and the target (targeted native α-Synuclein (aSyn) epitope coupled to bovine serum albumin (BSA) (mandatory) or presented in different forms - particularly monomers, pre-fibrils and fibrils (optional)) assessed by Enzyme-Linked Immunosorbent Assay (ELlSA) (or an equivalent method)
Time Frame
52 weeks
Title
Imaging efficacy variables at visit 6 (or EDV) compared to baseline
Description
11C-Pittsburgh Compound B (11C-PIB), 18F-Fluorodeoxyglucose-Positron Emission Tomography (18F-FDG-PET), resting-state functional magnetic resonance imaging (fMRI), diffusion-weighted/tensor magnetic resonance imaging (MRI), Magnetic Resonance-Spectroscopy
Time Frame
52 weeks
Title
Biomarker data at visit 6 (or EDV) compared to baseline
Description
β-Glucocerebrosidase (GCase) enzyme activity
Time Frame
52 weeks
Other Pre-specified Outcome Measures:
Title
Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) I, II, III and IV at visit 5 and visit 6 (or EDV) compared to baseline
Description
Change in motor/non-motor symptoms over time
Time Frame
52 weeks
Title
Parkinson's Disease Quality of Life-39 (PDQ-39) at visit 5 and visit 6 (or EDV) compared to baseline
Description
Change in non-motor PD symptoms over time
Time Frame
52 weeks
Title
Investigator's global evaluation scale at visit 5 and visit 6 (or EDV)
Description
Change in motor PD symptoms over time. The overall change in the severity of patient's illness, compared to patient's condition at the start of this clinical trial (Visit 1).
Time Frame
52 weeks
Title
Cognitive scales at visit 5 and visit 6 (or EDV) compared to baseline
Description
Change in non-motor PD symptoms over time (MOCA, Trail Making Test (TMF) A and B)
Time Frame
52 weeks
Title
Geriatric Depression Scale at visit 5 and visit 6 (or EDV) compared to baseline
Description
Change in non-motor PD symptoms over time
Time Frame
52 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
40 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Confirmed diagnosis of Parkinson's disease and confirmed carrier status for a heterozygous GBA mutation (PDGBA) Individuals who present in Hoehn&Yahr Stages I/II/III and fulfill the United Kingdom Parkinson's Disease Society Brain Bank Criteria Confirmed carrier status for a heterozygous GBA mutation (PDGBA)-The result of the MRI scan of the patient's brain has to be consistent with the diagnosis of PD Written informed consent signed and dated by the patient and, preferentially, the caregiver (caregiver is not mandatory) Age between 40 and 80 In the investigator's opinion, does not have visual or auditory impairments that would reduce the patients' ability to complete study questionnaires or be unable to receive instructions for these Female patients of childbearing potential are eligible if they use a medically accepted contraceptive method A potential participant treated with conventional PD therapies must be on stable doses for at least 3 months prior to Visit 1 and during the entire trial period Accepted PD medications include the following: levodopa (alone or in combination with benserazide, carbidopa), catechol-O-methyltransferase (COMT) inhibitors (entacapone, tolcapone), amantadine, non-ergot dopamine agonists (pramipexol, ropinirol, rotigotine), monoamine oxidase-B (MAO-B) inhibitors (rasagiline, selegiline) and anticholinergic medication A potential participant should be on stable doses of all medications he/she is taking because of consisting illnesses according to medical history (except PD therapies, these will be recorded separately) for at least 30 days prior to Visit 1 if considered relevant by the investigator Able to communicate well with the investigator, to understand and comply with the requirements of the study Exclusion Criteria: Pregnant women Sexually active women of childbearing potential who are not using a medically accepted birth control method Participation in another clinical trial within 3 months before Visit 1 History of questionable compliance to visit schedule; patients not expected to complete the clinical trial Presence or history of allergy to components of the vaccine if considered relevant by the investigator Contraindication for MRI imaging such as metallic implants (e.g. endoprosthesis, stents, cardiac pacemakers) which are not MR compatible at 3.0 Tesla with the given MR protocol, other foreign metal bodies (e.g. bullets, metal splinters, e.g.) or claustrophobia Missing agreement to be informed about incident findings and consultation of a neuroradiologist Contraindication for PET, that is, pregnancy and breast feeding. Ongoing participation in other interventional studies or clinical trials using radiotracers Dementia according to Diagnostic and Statistical Manual (DSM) IV criteria History and/or presence of autoimmune disease, if considered relevant by the investigator Recent (≤3 years since last specific treatment) history of cancer (Exceptions: non-melanoma skin cancer, intraepithelial cervical neoplasia) Active infectious disease (e.g., Hepatitis B, C) Presence and/or history of Immunodeficiency (e.g., HIV) Significant systemic illness (e.g., chronic renal failure, chronic liver disease, poorly controlled diabetes, poorly controlled congestive heart failure, other deficiencies), if considered relevant by the investigator History of significant psychiatric illness such as schizophrenia, bipolar affective disorder or psychotic depression Parkinson-like disease secondary to drug therapy side effects (e.g., due to exposure to medications that deplete dopamine [reserpine, tetrabenazine] or block dopamine receptors [neuroleptics, antiemetics]) Parkinson-plus syndromes (e.g., multiple system atrophy (MSA), progressive supranuclear palsy (PSP)), Dementia with Lewy Bodies (DLB) Heredodegenerative disorders other than PDGBA, evidence for other genetic forms of PD (e.g. LRRK2, Parkin gene mutations) Alcoholism or substance abuse within the past year (alcohol or drug intoxication) Prior and/or current treatment with experimental immunotherapeutics including Intravenous Immunoglobulin (IVIG) Prior and/or current treatment with immune modulating drugs: Interleukins, Interferons, Tumor Necrosis Factor (TNF) and analogues, colony stimulating factor compounds Ciclosporin, Tacrolimus, Sirolimus and analogues Cytostatic drugs and certain DMARD for rheumatoid arthritis (and similar autoimmune disorders) (e.g. Cyclophosphamid, Azathioprin, methotrexate, sulfasalazine, leflunomide, sodium aurothiomalate (Gold), cyclosporin) and analogues Systemic (gluco)corticoid therapy All antibody therapies (e.g., anti cluster of differentiation 3 (CD3), anti cluster of differentiation 25 (CD25) or also anti-lymphocyte globulins) that might modulate, enhance or weaken an immune response Change in dose of standard treatments for PD within 3 months prior to Visit 1 Change in dose of previous and current medications which the patient is taking because of consisting illnesses according medical history (except PD therapies, these will be recorded separately) within the last 30 days prior to Visit 1, if clinically relevant Treatment with deep brain stimulation Venous status rendering it impossible to place an i.v. access
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Thomas Gasser, Prof. Dr.
Organizational Affiliation
University Hospital Tübingen, 72076 Tübingen, Germany
Official's Role
Principal Investigator
Facility Information:
Facility Name
University Hospital Tübingen
City
Tübingen
ZIP/Postal Code
72076
Country
Germany

12. IPD Sharing Statement

Learn more about this trial

Study Assessing Tolerability and Safety and Exploring the Immunogenicity and Therapeutic Activity of AFFITOPE® PD01A in PD-GBA Patients

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