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Terbinafine Treatment of Axial Spondyloarthropathy (FUN)

Primary Purpose

Ankylosing Spondylitis, Axial Spondyloarthritis, Psoriatic Spondylitis

Status
Withdrawn
Phase
Early Phase 1
Locations
United States
Study Type
Interventional
Intervention
Terbinafine Tablets
Laboratory Testing
Laboratory Testing
Sponsored by
Oregon Health and Science University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Ankylosing Spondylitis focused on measuring fungus, malassezia, microbiome

Eligibility Criteria

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

Inclusion Criteria:

  • Subjects age 18 and older of either sex will be included.
  • Subjects must be willing and able to provide informed consent.
  • Subjects must have been diagnosed with ankylosing spondylitis, axial spondyloarthritis, psoriatic spondylitis or spondylitis secondary to inflammatory bowel disease by a physician and must be willing to request records to validate the diagnosis.
  • Subjects must complete a symptom questionnaire called a BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) and must have a score of four or above to indicate active disease and the potential to improve.
  • Subjects must agree to remain on a stable treatment regimen for their joint disease for the duration of the trial and for one month before the study begins.
  • Subjects must be willing to provide stool samples and be willing to have routine lab studies every 8 weeks during the duration of the study.

Exclusion Criteria:

  • Pregnant or lactating women will not be included.
  • Subjects must not be allergic or intolerant to terbinafine.
  • Subjects must not be taking medications that have the potential for serious interactions with terbinafine. These drugs include desipramine, cimetidine, fluconazole, cyclosporine and rifampin.
  • Subjects must not have taken antibiotics within 3 months of starting the study drug and collecting the baseline stool specimen.
  • Subjects with the following blood dyscrasias will not be included:

Hemoglobin <9g/dL or Hematocrit <30% White blood cell count <3.0 K/cu mm Absolute neutrophil count <1.2 K/cu mm Platelet count <100 K/cu mm Subjects with an estimated GFR ≤50 ml/min Subjects with a total bilirubin, AST, or ALT more than 1.5 times the upper limit of normal at screening.

  • Severe, progressive, or uncontrolled chronic liver disease including fibrosis, cirrhosis, or recent or active hepatitis.
  • History of any lymphoproliferative disorder such as Epstein Barr virus (EBV) related lymphoproliferative disorder, history of lymphoma, leukemia, or signs and symptoms suggest of current lymphatic disease.
  • Current malignancy or history of malignancy, with the exception of adequately treated or excised non-metastatic basal cell or squamous cell cancer of the skin, or cervical carcinoma in situ.
  • Have or have had an opportunistic infection (e.g., herpes zoster [shingles], cytomegalovirus, Pneumocystis carinii, aspergillosis and aspergilloma, histoplasmosis, or mycobacteria other than TB) within 6 months prior to screening.
  • Have a known infection with human immunodeficiency virus (HIV)
  • Have current signs and symptoms of systemic lupus erythematosus, or severe, progressive, or uncontrolled renal, hepatic, hematologic, endocrine, pulmonary, cardiac (New York Heart Association class III or IV), neurologic, or cerebral diseases.

Sites / Locations

  • Oregon Health & Science University

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Active Comparator

Arm Label

Placebo to Drug

Drug to Placebo

Arm Description

Subjects will begin treatment on placebo then crossover to study drug.

Subjects will begin treatment on study drug then crossover to placebo.

Outcomes

Primary Outcome Measures

Change in BASDAI score
BASDAI score after the completion of 16 weeks of terbinafine treatment versus the BASDAI score after 16 weeks on placebo. Benefit is defined by a reduction of BASDAI score of 2 or more.

Secondary Outcome Measures

Full Information

First Posted
November 3, 2021
Last Updated
August 24, 2023
Sponsor
Oregon Health and Science University
Collaborators
The Malassezia Foundation
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1. Study Identification

Unique Protocol Identification Number
NCT05119712
Brief Title
Terbinafine Treatment of Axial Spondyloarthropathy
Acronym
FUN
Official Title
Terbinafine Treatment of Axial Spondyloarthropathy
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Withdrawn
Why Stopped
Study stopped due to poor recruitment.
Study Start Date
March 9, 2021 (Actual)
Primary Completion Date
October 15, 2023 (Anticipated)
Study Completion Date
October 15, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Oregon Health and Science University
Collaborators
The Malassezia Foundation

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
This is a pilot study to determine if further research is warranted to assess if anti-fungal therapy is an effective adjunctive treatment for axial spondyloarthropathy
Detailed Description
The purpose of this trial is to determine if terbinafine is an effective therapy for ankylosing spondylitis. Benefit will be determined by a reduction of the BASDAI by two or more. The primary endpoint is the BASDAI at the completion of 16 weeks of terbinafine versus the BASDAI at the start of the trial and at the completion of the placebo. The secondary endpoint with the percent of patients whose BASDAI improves by two or more while on terbinafine (week 16) versus the percent of subjects with a similar improvement after 16 weeks of placebo.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Ankylosing Spondylitis, Axial Spondyloarthritis, Psoriatic Spondylitis, Spondylitis Secondary to Inflammatory Bowel Disease, Axial Spondyloarthopathy
Keywords
fungus, malassezia, microbiome

7. Study Design

Primary Purpose
Treatment
Study Phase
Early Phase 1
Interventional Study Model
Crossover Assignment
Model Description
Subjects will receive either terbinafine 500 mg or placebo for 16 weeks and then crossed over to the opposite therapy for another 16 weeks.
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
0 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Placebo to Drug
Arm Type
Active Comparator
Arm Description
Subjects will begin treatment on placebo then crossover to study drug.
Arm Title
Drug to Placebo
Arm Type
Active Comparator
Arm Description
Subjects will begin treatment on study drug then crossover to placebo.
Intervention Type
Drug
Intervention Name(s)
Terbinafine Tablets
Other Intervention Name(s)
Lamisil
Intervention Description
500mg oral terbinafine or placebo daily
Intervention Type
Diagnostic Test
Intervention Name(s)
Laboratory Testing
Other Intervention Name(s)
Blood work
Intervention Description
Laboratory testing at screening, baseline, week 8, 16, 24 and 32.
Intervention Type
Diagnostic Test
Intervention Name(s)
Laboratory Testing
Other Intervention Name(s)
Urinalysis
Intervention Description
Subjects with the potential to become pregnant will have a baseline urine pregnancy test prior to starting study drug.
Primary Outcome Measure Information:
Title
Change in BASDAI score
Description
BASDAI score after the completion of 16 weeks of terbinafine treatment versus the BASDAI score after 16 weeks on placebo. Benefit is defined by a reduction of BASDAI score of 2 or more.
Time Frame
16 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subjects age 18 and older of either sex will be included. Subjects must be willing and able to provide informed consent. Subjects must have been diagnosed with ankylosing spondylitis, axial spondyloarthritis, psoriatic spondylitis or spondylitis secondary to inflammatory bowel disease by a physician and must be willing to request records to validate the diagnosis. Subjects must complete a symptom questionnaire called a BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) and must have a score of four or above to indicate active disease and the potential to improve. Subjects must agree to remain on a stable treatment regimen for their joint disease for the duration of the trial and for one month before the study begins. Subjects must be willing to provide stool samples and be willing to have routine lab studies every 8 weeks during the duration of the study. Exclusion Criteria: Pregnant or lactating women will not be included. Subjects must not be allergic or intolerant to terbinafine. Subjects must not be taking medications that have the potential for serious interactions with terbinafine. These drugs include desipramine, cimetidine, fluconazole, cyclosporine and rifampin. Subjects must not have taken antibiotics within 3 months of starting the study drug and collecting the baseline stool specimen. Subjects with the following blood dyscrasias will not be included: Hemoglobin <9g/dL or Hematocrit <30% White blood cell count <3.0 K/cu mm Absolute neutrophil count <1.2 K/cu mm Platelet count <100 K/cu mm Subjects with an estimated GFR ≤50 ml/min Subjects with a total bilirubin, AST, or ALT more than 1.5 times the upper limit of normal at screening. Severe, progressive, or uncontrolled chronic liver disease including fibrosis, cirrhosis, or recent or active hepatitis. History of any lymphoproliferative disorder such as Epstein Barr virus (EBV) related lymphoproliferative disorder, history of lymphoma, leukemia, or signs and symptoms suggest of current lymphatic disease. Current malignancy or history of malignancy, with the exception of adequately treated or excised non-metastatic basal cell or squamous cell cancer of the skin, or cervical carcinoma in situ. Have or have had an opportunistic infection (e.g., herpes zoster [shingles], cytomegalovirus, Pneumocystis carinii, aspergillosis and aspergilloma, histoplasmosis, or mycobacteria other than TB) within 6 months prior to screening. Have a known infection with human immunodeficiency virus (HIV) Have current signs and symptoms of systemic lupus erythematosus, or severe, progressive, or uncontrolled renal, hepatic, hematologic, endocrine, pulmonary, cardiac (New York Heart Association class III or IV), neurologic, or cerebral diseases.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Atul Deodhar, M.D.
Organizational Affiliation
Oregon Health and Science University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Oregon Health & Science University
City
Portland
State/Province
Oregon
ZIP/Postal Code
97239
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
IPD Sharing Plan Description
There is no plan to share IPD with other researchers.
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Terbinafine Treatment of Axial Spondyloarthropathy

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