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Study of Bacteroides Thetaiotaomicron in Young People Aged 16 to 18 Years With Stable Crohn's Disease

Primary Purpose

Crohn's Disease

Status
Completed
Phase
Not Applicable
Locations
United Kingdom
Study Type
Interventional
Intervention
Thetanix
Placebo
Sponsored by
4D pharma plc
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Crohn's Disease

Eligibility Criteria

16 Years - 18 Years (Child, Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Subjects aged 16 to 18 years inclusive, with confirmed diagnosis of Crohn's disease who are currently in clinical remission* in the opinion of the investigator and who are otherwise healthy.
  2. Subjects who are able and willing to give written informed consent to participate. If applicable, a parent/carer may also give consent to their participation.

Exclusion Criteria:

  1. Subjects who are pregnant or breastfeeding.
  2. Subject who are experiencing an exacerbation at the time of screening or up to the time of the first dose.
  3. Subjects who have undergone previous surgery for resection of bowel.
  4. Subjects who have fistulisation.
  5. Subjects who have had a significant change in their immune-modulating maintenance medication in the 3 months prior to screening and/or the start of dosing.
  6. Subjects who have taken systemic steroids in the last 3 months.
  7. Subjects who are unable to take any oral feeding.
  8. Subjects with feeding gastrostomies.
  9. Subjects who have non-food dietary supplementation for any reason changed within 1 month prior to dosing.
  10. Subjects who have received monoclonal antibodies in the 6 months prior to dosing.
  11. Subjects who have received antibiotics or probiotic dietary supplementation in the two weeks before dosing. Subjects who have received foods with probiotics e.g. yoghurts will be permitted to volunteer for the study.
  12. Subjects who are receiving exclusive enteral feeding or have completed a course of exclusive enteral feeding in the 3 months prior to dosing.
  13. Subjects with concomitant autoimmune diseases.
  14. Female Subjects of child bearing potential unwilling to use effective contraception from the signing of the consent form until completion of two periods after the last dose. An effective method of birth control is defined as one which results in a low failure rate (i.e. less than 1% per year) when used consistently and correctly such as sterilisation, implants, injectables, combined oral contraceptives, Intrauterine Device (IUD), condoms, occlusive caps (cervical/vault caps) with spermicidal foam/gel/film/cream/pessary. True sexual abstinence is acceptable when this is in line with the preferred and usual lifestyle of the subject.
  15. Subjects with clinically significantly, in the opinion of the investigator, elevated platelets, white cell count, C-reactive protein, erythrocyte sedimentation rate (ESR), low albumin or haemoglobin.
  16. Subjects who are positive for the following viruses: HIV, hepatitis B and hepatitis C.
  17. Subjects who smoke cigarettes or use other tobacco or nicotine containing products, including e-cigarettes.
  18. Subjects who have a known sensitivity to any of the constituents of the investigational medicinal compound.
  19. Diastolic blood pressure <50 or >90 mmHg, a systolic blood pressure <100 or >150 mmHg, a pulse <40 or >100 beats per minute (bpm) after resting for 5 minutes.
  20. Subjects with clinically significantly abnormal ECGs or structural cardiac abnormalities e.g. valvular heart disease, patent foramen ovale.
  21. BMI Z SCORE less than -2.6 or greater than 2.6 (0 ± 2.6); i.e. below the 2nd centile or greater than the 98th centile.
  22. Any condition that, in the opinion of the Investigator, might interfere with the primary study objective.
  23. Subjects allergic to metronidazole and co-amoxiclav

Sites / Locations

  • Birmingham Children's Hospital
  • Clinical Research Facility
  • Clinical Research Faciity
  • Alder Hey Children's Hospital
  • Barts Health NHS Trust

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Thetanix

Placebo

Arm Description

In Part A, 8 subjects will receive a single dose and in Part B, 8 subjects will receive twice daily doses for 7.5 days (a total of 15 doses). Each dose consists of three capsules

In Part A, 2 subjects will receive a single dose and in Part B, 2 subjects will receive twice daily doses for 7.5 days (a total of 15 doses). Each dose consists of three capsules.

Outcomes

Primary Outcome Measures

Incidence of treatment emergent adverse events
The change from baseline will be assessed at Day 7 (Part A) and at Day 14 (Part B). Part A and Part B will be analysed separately as they are of different duration. The primary endpoint for each part is taken as 7 days after the last dose.

Secondary Outcome Measures

Physician Global Assessment
Change in Physician Global Assessment
Weighted Paediatric Crohn's Disease Activity Index
Change in Weighted Paediatric Disease Activity Index
The number of subjects with abnormal clinically and non-clinically significant or out of expected range tests.
Tests include: Serum biochemistry and haematology; physical examinations, blood pressure, pulse rate, respiratory rate and oral temperature, weight, height, ECG parameters.
Part A: Faecal Microbiome Part B Microbiome and faecal calprotectin concentrations
Stool samples will be collected and analysed for faecal calprotectin and microbial communities with specific interest in B. theta.

Full Information

First Posted
January 12, 2016
Last Updated
June 27, 2018
Sponsor
4D pharma plc
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1. Study Identification

Unique Protocol Identification Number
NCT02704728
Brief Title
Study of Bacteroides Thetaiotaomicron in Young People Aged 16 to 18 Years With Stable Crohn's Disease
Official Title
A Randomised, Double-blind, Placebo-controlled Study to Assess the Safety and Tolerability of Bacteroides Thetaiotaomicron in Young People Aged 16 to 18 Years With Stable Crohn's Disease
Study Type
Interventional

2. Study Status

Record Verification Date
June 2018
Overall Recruitment Status
Completed
Study Start Date
December 2015 (Actual)
Primary Completion Date
April 2018 (Actual)
Study Completion Date
April 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
4D pharma plc

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to assess the safety and tolerability of Bacteroides thetaiotaomicron (Thetanix®)) capsules in young people aged 16 to 18 years with stable Crohn's disease.
Detailed Description
This study is a single (Part A) and multiple (Part B) dose study. Following informed consent and screening, 10 eligible subjects will receive a single dose of Thetanix or placebo in the clinic. A Safety Review Committee will review the safety data up to Day 7 from these first ten subjects and determine if it is appropriate to continue into Part B in which 10 subjects will receive 15 doses of Thetanix or placebo in a twice daily dosing regimen over 7.5 days. In both parts of the study, 8 of the 10 subjects will randomly receive Thetanix and 2 subjects will randomly receive placebo. Each dose consists of three capsules. Subjects in Part B will receive the first and last dose in the clinic and will take 13 doses at home. While at home, subjects will be required to answer questions about their health, record their body temperature and when they take the capsules in an electronic diary. Subjects developing a fever will undergo further assessments, including blood cultures. Subjects will provide stool samples for analysis of microbiota and faecal calprotectin.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Crohn's Disease

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
18 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Thetanix
Arm Type
Experimental
Arm Description
In Part A, 8 subjects will receive a single dose and in Part B, 8 subjects will receive twice daily doses for 7.5 days (a total of 15 doses). Each dose consists of three capsules
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
In Part A, 2 subjects will receive a single dose and in Part B, 2 subjects will receive twice daily doses for 7.5 days (a total of 15 doses). Each dose consists of three capsules.
Intervention Type
Other
Intervention Name(s)
Thetanix
Other Intervention Name(s)
B. theta
Intervention Description
Thetanix is an encapsulated lyophilised formulation of a pure culture of Bacteroides thetaiotaomicron with excipients.
Intervention Type
Other
Intervention Name(s)
Placebo
Intervention Description
Placebo is encapsulated microcrystalline cellulose without Bacteroides thetaiotaomicron.
Primary Outcome Measure Information:
Title
Incidence of treatment emergent adverse events
Description
The change from baseline will be assessed at Day 7 (Part A) and at Day 14 (Part B). Part A and Part B will be analysed separately as they are of different duration. The primary endpoint for each part is taken as 7 days after the last dose.
Time Frame
Part A (single dose): Day 7. Part B (15 doses over 7.5 days): Day 14
Secondary Outcome Measure Information:
Title
Physician Global Assessment
Description
Change in Physician Global Assessment
Time Frame
Part B: Day 14
Title
Weighted Paediatric Crohn's Disease Activity Index
Description
Change in Weighted Paediatric Disease Activity Index
Time Frame
Part B; Day 14
Title
The number of subjects with abnormal clinically and non-clinically significant or out of expected range tests.
Description
Tests include: Serum biochemistry and haematology; physical examinations, blood pressure, pulse rate, respiratory rate and oral temperature, weight, height, ECG parameters.
Time Frame
Part A: Day 7; Part B: Day 14
Title
Part A: Faecal Microbiome Part B Microbiome and faecal calprotectin concentrations
Description
Stool samples will be collected and analysed for faecal calprotectin and microbial communities with specific interest in B. theta.
Time Frame
Part B: Day 14

10. Eligibility

Sex
All
Minimum Age & Unit of Time
16 Years
Maximum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subjects aged 16 to 18 years inclusive, with confirmed diagnosis of Crohn's disease who are currently in clinical remission* in the opinion of the investigator and who are otherwise healthy. Subjects who are able and willing to give written informed consent to participate. If applicable, a parent/carer may also give consent to their participation. Exclusion Criteria: Subjects who are pregnant or breastfeeding. Subject who are experiencing an exacerbation at the time of screening or up to the time of the first dose. Subjects who have undergone previous surgery for resection of bowel. Subjects who have fistulisation. Subjects who have had a significant change in their immune-modulating maintenance medication in the 3 months prior to screening and/or the start of dosing. Subjects who have taken systemic steroids in the last 3 months. Subjects who are unable to take any oral feeding. Subjects with feeding gastrostomies. Subjects who have non-food dietary supplementation for any reason changed within 1 month prior to dosing. Subjects who have received monoclonal antibodies in the 6 months prior to dosing. Subjects who have received antibiotics or probiotic dietary supplementation in the two weeks before dosing. Subjects who have received foods with probiotics e.g. yoghurts will be permitted to volunteer for the study. Subjects who are receiving exclusive enteral feeding or have completed a course of exclusive enteral feeding in the 3 months prior to dosing. Subjects with concomitant autoimmune diseases. Female Subjects of child bearing potential unwilling to use effective contraception from the signing of the consent form until completion of two periods after the last dose. An effective method of birth control is defined as one which results in a low failure rate (i.e. less than 1% per year) when used consistently and correctly such as sterilisation, implants, injectables, combined oral contraceptives, Intrauterine Device (IUD), condoms, occlusive caps (cervical/vault caps) with spermicidal foam/gel/film/cream/pessary. True sexual abstinence is acceptable when this is in line with the preferred and usual lifestyle of the subject. Subjects with clinically significantly, in the opinion of the investigator, elevated platelets, white cell count, C-reactive protein, erythrocyte sedimentation rate (ESR), low albumin or haemoglobin. Subjects who are positive for the following viruses: HIV, hepatitis B and hepatitis C. Subjects who smoke cigarettes or use other tobacco or nicotine containing products, including e-cigarettes. Subjects who have a known sensitivity to any of the constituents of the investigational medicinal compound. Diastolic blood pressure <50 or >90 mmHg, a systolic blood pressure <100 or >150 mmHg, a pulse <40 or >100 beats per minute (bpm) after resting for 5 minutes. Subjects with clinically significantly abnormal ECGs or structural cardiac abnormalities e.g. valvular heart disease, patent foramen ovale. BMI Z SCORE less than -2.6 or greater than 2.6 (0 ± 2.6); i.e. below the 2nd centile or greater than the 98th centile. Any condition that, in the opinion of the Investigator, might interfere with the primary study objective. Subjects allergic to metronidazole and co-amoxiclav
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Richard Hansen, MB ChB PhD FRCPCH
Organizational Affiliation
South Glasgow University Hospitals NHS Trust
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
David Wilson, MD DCH FRCP(Edin) FRCPCH
Organizational Affiliation
Royal Hospital for Sick Children Edinburgh
Official's Role
Principal Investigator
Facility Information:
Facility Name
Birmingham Children's Hospital
City
Birmingham
State/Province
Birmimgham
ZIP/Postal Code
B46NH
Country
United Kingdom
Facility Name
Clinical Research Facility
City
Edinburgh
ZIP/Postal Code
EH6 1LF
Country
United Kingdom
Facility Name
Clinical Research Faciity
City
Glasgow
ZIP/Postal Code
G514TF
Country
United Kingdom
Facility Name
Alder Hey Children's Hospital
City
Liverpool
ZIP/Postal Code
L12 2AP
Country
United Kingdom
Facility Name
Barts Health NHS Trust
City
London
ZIP/Postal Code
E1 1BB
Country
United Kingdom

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
33464732
Citation
Hansen R, Sanderson IR, Muhammed R, Allen S, Tzivinikos C, Henderson P, Gervais L, Jeffery IB, Mullins DP, O'Herlihy EA, Weinberg JD, Kitson G, Russell RK, Wilson DC. A Double-Blind, Placebo-Controlled Trial to Assess Safety and Tolerability of (Thetanix) Bacteroides thetaiotaomicron in Adolescent Crohn's Disease. Clin Transl Gastroenterol. 2020 Dec 18;12(1):e00287. doi: 10.14309/ctg.0000000000000287.
Results Reference
derived

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Study of Bacteroides Thetaiotaomicron in Young People Aged 16 to 18 Years With Stable Crohn's Disease

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