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Well tolerated but failed to demonstrate significant activity. So it did not meet its primary endpoint or key secondary endpoints.
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The primary objective of this study is to evaluate and compare the safety and efficacy of Trichuris suis ova (TSO) therapy (versus placebo) in pediatric patients with autism.
Evaluation of the safety and tolerability of treatment with TSO in the target population across the dose range being tested is considered a primary objective, while the primary efficacy objective will be assessed via the change from baseline in the Aberrant Behavior Checklist (ABC) subscale scores.
Dose response will be considered a primary objective as well.
Secondary assessments of efficacy will be assessed via:
• The change from baseline in the Clinical Global Impression scale (CGI-I)
This is a randomized, three-arm double-blind, placebo-controlled, single-center study to evaluate the effects of oral administration of Trichuris suis ova (as compared to placebo) in the treatment of pediatric patients diagnosed with Autism. The target sample size to be randomized into the study will be approximately 60, randomly assigned in a 1:1:1 ratio to one of three treatment groups:
Double-blind treatment will be given for a total of 16 weeks.
This study will have 3 phases:
After completion of the double-blind phase, patients will then return to the clinic 26 weeks following the last dose of study medication for a safety assessment and stool sample culture.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| TSO 2500 | Active Comparator | 2500 TSO every other week |
|
| 7500 TSO | Active Comparator | 7500 TSO every other week |
|
| Placebo | Placebo Comparator | placebo every other week. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| TSO | Drug | There is evidence of a relationship between ASD symptomatology and immune dysfunction suggests that immunomodulatory treatments effective in other autoimmune disorders might be investigated in ASD, including Trichuris Ova Suis (TSO), a helminth porcine whipworm |
| Measure | Description | Time Frame |
|---|---|---|
| Aberrant Behavior Checklist (ABC) subscale scores | The ABC consists of 58 questions and the five subscales as described above. Each question on the ABC is rated on a 4-point scale: 0 = 'not a problem,' 1 ='the behavior is a problem but slight in degree,' 2 = 'the problem is moderately serious,' and 3 = 'the problem is severe in degree.' The subscale score is the sum of the responses to the questions that make up the subscale. | 16 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Secondary assessments of efficacy will be assessed via: The change from baseline in the CY-BOCS, CGI-I, SRS, SCQ. | Secondary assessments of efficacy will be assessed via: • The change from baseline in the Clinical Global Impression - Improvement scale (CGI-I) | 49 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Clinical Laboratory | Clinical laboratories will include hematology and serum chemistry panels, as well as C-reactive protein | 49 weeks |
Inclusion Criteria:
Males or females, ages 6 to 17 years, inclusive
Diagnosis via Diagnostic and Statistical Manual for Mental Disorders- Forth Edition (DSM-IV)-and confirmed by Autism Diagnostic Observation
Schedule (ADOSI):
CGI-Severity score > 4 and ABC irritability score > 18
Mental age of > 18 months
Weight of at least ** kg
Currently psychotropic medication free or on stable dose of psychotropic medication for at least 3 months prior to the study.
Willing to comply with the schedule of study visits and protocol requirements
Patient and/or guardian have the ability to provide informed consent
Exclusion Criteria:
Previous diagnosis of Rett's Disorder, Aspergers Disorder, Childhood Disintegrative Disorder, Fragile X Syndrome, or other disorders on the autism spectrum
History of Bipolar Disorder, Psychotic Disorders, or major Depression
Seizure within the previous 6 months
Patient received antibiotic, antifungal or antiparasitic medication in the last 2 weeks prior to Screening and/or would potentially require this during the study treatment period
Patient with history of drug or alcohol abuse within 6 months prior to Screening
Patient with evidence of poor compliance with medical advice and instruction including diet or medication
Patient is unable or unwilling to swallow study medication suspension
Patient with a significant medical condition which puts the patient at risk for study participation and/or for any reason is considered by the Investigator to be an unsuitable candidate to receive TSO or is potentially put at risk by study procedures
Patient who has participated in another clinical trial within 30 days of Screening for this trial and/or any experimental treatment for this population
Females of childbearing potential who are unwilling or unable to use an acceptable method to avoid pregnancy for the entire study period
Females who are pregnant or breastfeeding at the time of enrollment
Patients with any of the following laboratory values:
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| Name | Affiliation | Role |
|---|---|---|
| Itai Berger, MD | Hadassah Medical Organization | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The Neuro-Cognitive Center, Pediatric Division, Hadassah-Hebrew University Medical Center | Jerusalem | Mount Scopus | 91240 | Israel |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 15591509 | Background | Summers RW, Elliott DE, Urban JF Jr, Thompson R, Weinstock JV. Trichuris suis therapy in Crohn's disease. Gut. 2005 Jan;54(1):87-90. doi: 10.1136/gut.2004.041749. | |
| 21372112 | Background | Fleming JO, Isaak A, Lee JE, Luzzio CC, Carrithers MD, Cook TD, Field AS, Boland J, Fabry Z. Probiotic helminth administration in relapsing-remitting multiple sclerosis: a phase 1 study. Mult Scler. 2011 Jun;17(6):743-54. doi: 10.1177/1352458511398054. Epub 2011 Mar 3. |
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| ID | Term |
|---|---|
| D000067877 | Autism Spectrum Disorder |
| D001321 | Autistic Disorder |
| D001519 | Behavior |
| ID | Term |
|---|---|
| D002659 | Child Development Disorders, Pervasive |
| D065886 | Neurodevelopmental Disorders |
| D001523 | Mental Disorders |
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| ID | Term |
|---|---|
| D004864 | Equipment and Supplies |
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| Placebo | Drug |
|