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MFR's business decision to d/c TSO production -unrelated to any safety concern.
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| Name | Class |
|---|---|
| Coronado Biosciences, Inc. | INDUSTRY |
| Autoimmunity Centers of Excellence | OTHER |
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The purpose of this study is to evaluate the safety and effectiveness of trichuris suis ova (TSO) in ulcerative colitis (UC). We will look at how TSO affects the body's immune response and if there are related changes in participants' UC.
The cause of UC, an inflammatory bowel disease (IBD), is not well understood. It is believed to be caused from an abnormal immune response to the normal bacteria that live in the gut (intestines and colon). This response acts as an "attack" on the healthy tissue of the bowel by a person's own immune cells which leads to disease.
It is well known that autoimmune diseases such as IBD, asthma, diabetes, and multiple sclerosis are more common in industrialized, well-developed countries with better sanitation and hygiene, as in the United States. These "cleaner" environments reduce exposure to germs and parasites naturally found in the environment. This reduced exposure may trigger responses in the body that make people more prone to diseases such as UC. People in non-industrialized countries and the tropics, where parasites are common, rarely develop these diseases. This observation has led researchers to want to better understand the relationship between the lack of natural bacteria in the gut and the onset of autoimmune diseases like as UC.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Trichuris suis ova (TSO) | Experimental | Six doses of TSO orally over a ten-week period |
|
| Placebo | Placebo Comparator | Six doses of TSO placebo orally over a ten-week period |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Trichuris suis ova (TSO) | Biological | Six doses of TSO orally over a ten-week period (e.g., every 2 weeks x 10 weeks for a total of 6 total doses) |
|
| Measure | Description | Time Frame |
|---|---|---|
| Percentage of Participants Who Achieved a Clinical Response at Week 12 | Clinical response is defined as a reduction in the Mayo score of at least 3 points and at least a 30% reduction from Baseline, along with either a decrease from Baseline in the rectal bleeding subscore of more than 1 point or a rectal bleeding subscore of 0 or 1. | Week 12 |
| Measure | Description | Time Frame |
|---|---|---|
| Percent of Participants Who Achieved Remission at Week 12 | Remission is defined as a Mayo score of less than or equal to 1 with absence of rectal bleeding and endoscopy score of 0 or 1. | Week 12 |
| Percent of Participants With Healed Colonic Mucosa at Week 12 |
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Inclusion Criteria:
Subject has provided written informed consent
Diagnosis of UC (newly diagnosed or established patients) as determined by medical history, endoscopic and histological confirmation with the proximal disease extent limited to the left colon (distal to the splenic flexure), and accessible by flexible sigmoidoscopy. Patients with left-sided disease and the presence of a periappendiceal red patch (limited cecal inflammation) will be eligible as long as there is no intervening evidence of colitis between the cecal base and the upper boundary of inflammation in the left colon.
Mayo score >/= 4, as scored at Screen 2
If taking the following medications at Screen 1, subjects must meet the following criteria:
Exclusion Criteria:
Subjects whose UC is anticipated to require surgical, endoscopic, or radiologic intervention during study participation
Uncontrolled GI bleeding
Subjects who have disease limited to the rectum (maximum disease extent of less than 15 cm)
Women who are pregnant, breast-feeding, or planning to become pregnant during the study. All women of childbearing potential must have a negative serum pregnancy test at Screen 2 prior to randomization of treatment.
Women of childbearing potential not using adequate birth control measures (e.g., total abstinence, oral contraceptives, intrauterine device, barrier method with spermicide, surgical sterilization, Depo-Provera, or hormonal implants).
Current or recent serious systemic disorder including clinically significant impairment in cardiac, pulmonary, liver, renal, endocrine, hematologic, or neurologic function, based on investigator discretion
Subjects currently receiving the following concomitant medications:
Blood transfusion within the 12 weeks prior to Day 0
Presence of any of the following abnormal laboratory parameters at Screen 1:
History of drug or alcohol abuse within one year prior to Day 0
Inability to understand the nature and requirements of the study, or to comply with the study procedures or planned schedule of study visits
Evidence of infection with human immunodeficiency virus (HIV), hepatitis B, or hepatitis C
Active infection with C. difficile, bacterial enteric pathogens, or pathogenic ova/parasites
History of malignancy within the last 5 years, except for resected basal or squamous cell carcinoma, treated cervical dysplasia, or treated in situ cervical cancer Grade I
History of colonic dysplasia
Any social or medical condition that, in the opinion of the investigator, would preclude provision of informed consent, make participation in the study unsafe, complicate interpretation of study outcome data, or otherwise interfere with achieving the study objectives.
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| Name | Affiliation | Role |
|---|---|---|
| Stephen Hanauer, MD | Northwestern University | Study Chair |
| Bana Jabri, MD, PhD | University of Chicago | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Stanford University School of Medicine | Palo Alto | California | 94305 | United States | ||
| Yale University |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 14499784 | Background | Summers RW, Elliott DE, Qadir K, Urban JF Jr, Thompson R, Weinstock JV. Trichuris suis seems to be safe and possibly effective in the treatment of inflammatory bowel disease. Am J Gastroenterol. 2003 Sep;98(9):2034-41. doi: 10.1111/j.1572-0241.2003.07660.x. | |
| 15677912 | Background | Moreels TG, Pelckmans PA. Gastrointestinal parasites: potential therapy for refractory inflammatory bowel diseases. Inflamm Bowel Dis. 2005 Feb;11(2):178-84. doi: 10.1097/00054725-200502000-00012. |
| Label | URL |
|---|---|
| National Institute of Allergy and Infectious Diseases (NIAID) website | View source |
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Of all the participating sites, nine reached the study intervention randomization phase for >=one participant.The first site was activated in November 2013 and the last participant was randomized in March 2015.
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| ID | Title | Description |
|---|---|---|
| FG000 | TSO 7500 | Participants were randomized to receive six doses of 7500 viable, embryonated Trichuris suis ova (TSO) in liquid suspension orally over a 10-week period. |
| FG001 | Placebo |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
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| Placebo | Biological | Six doses of TSO placebo orally over a ten-week period (e.g., every 2 weeks x 10 weeks for a total of 6 total doses) |
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Healed colonic mucosa is defined as a Mayo endoscopy score of 0 or 1. |
| Week 12 |
| Percent of Participants With a Modified Clinical Response | Modified clinical response is defined as a reduction in the modified Mayo score (i.e., minus the endoscopy component) of at least 2 points from baseline. | From Day 0 through time of first clinical response or end of follow-up, whichever comes first, up to 12 Weeks |
| Time to Modified Clinical Response | Number of days to reach a modified clinical response. Modified clinical response is defined as a reduction in the modified Mayo score (i.e., minus the endoscopy component) of at least 2 points from baseline. | From Baseline through the day that modified clinical response is reached. Week 16 is the last visit that the modified Mayo score is assessed. |
| Percent of Participants With Colonoscopic Evidence of Visible Worm | Stool evaluations for ova and parasites confirmed the absence of T. suis. If evidence suggested a presence of T. suis, a colonoscopy would be performed to confirm invasion with a visible worm. | From Day 0 through end of follow-up, up to 36 weeks |
| Percent of Participants With Increase in Diarrhea | An increase in diarrhea is defined as an increase in the Mayo Score's Stool Frequency score by at least 1 point from baseline at any time during follow-up. | From Day 0 through end of follow-up, up to 36 weeks |
| Percent of Participants With Increase in Concurrent Ulcerative Colitis (UC) Medications or New Rescue Medications Added | New or increase in UC medications is defined as a need for dose-escalation of concurrent medications or need for rescue medications to treat UC through Week 16. | From Day 0 through Week 16 |
| New Haven |
| Connecticut |
| 06510 |
| United States |
| University of Miami Miller School of Medicine | Miami | Florida | 33136 | United States |
| Northwestern University Feinberg School of Medicine | Chicago | Illinois | 60611 | United States |
| University of Chicago | Chicago | Illinois | 60637 | United States |
| University of Iowa Hospital | Iowa City | Iowa | 52242 | United States |
| University of Maryland | Baltimore | Maryland | 21201 | United States |
| Tufts Medical Center | Boston | Massachusetts | 02111 | United States |
| Mayo Clinic | Rochester | Minnesota | 55905 | United States |
| Weill Cornell Medical College | New York | New York | 10021 | United States |
| Duke University Medical Center | Durham | North Carolina | 27710 | United States |
| Cleveland Clinic | Cleveland | Ohio | 44195 | United States |
| Drexel University | Philadelphia | Pennsylvania | 19103 | United States |
| University of Pittsburgh | Pittsburgh | Pennsylvania | 15213 | United States |
| Vanderbilt University | Nashville | Tennessee | 37212 | United States |
| Baylor College of Medicine | Houston | Texas | 77030 | United States |
| Virginia Mason Medical Center | Seattle | Washington | 98101 | United States |
| 17499605 | Background | Baumgart DC, Carding SR. Inflammatory bowel disease: cause and immunobiology. Lancet. 2007 May 12;369(9573):1627-40. doi: 10.1016/S0140-6736(07)60750-8. |
Participants were randomized to receive six doses of placebo in liquid suspension orally over a 10-week period.
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| NOT COMPLETED |
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The Randomized population included all subjects who were randomized to receive either TSO 7500 or placebo.
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| ID | Title | Description |
|---|---|---|
| BG000 | TSO 7500 | Participants were randomized to receive six doses of 7500 viable, embryonated Trichuris suis ova (TSO) in liquid suspension orally over a 10-week period. |
| BG001 | Placebo | Participants were randomized to receive six doses of placebo in liquid suspension orally over a 10-week period. |
| BG002 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean | Standard Deviation | years |
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| Sex: Female, Male | Count of Participants | Participants |
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| Ethnicity (NIH/OMB) | Count of Participants | Participants |
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| Race (NIH/OMB) | Count of Participants | Participants |
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| Region of Enrollment | Number | participants |
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| Percentage of Participants at Baseline Who Were Taking a Corticosteroid | Percentage of participants at Baseline who were taking a corticosteroid prescribed by a physician. | Number | percentage of participants |
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| Percentage of Participants at Baseline Who Were Taking Thiopurine | Percentage of participants at Baseline who were taking Thiopurine prescribed by a physician. | Number | percentage of participants |
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| Mayo Score for Assessment of Ulcerative Colitis Activity | The Mayo Score assesses four areas of ulcerative colitis activity: stool frequency, rectal bleeding, endoscopic findings, and physician's global assessment. The physician rates each of the four areas on a scale of 0 to 3, with a total possible score of 12. A higher score indicates more disease activity. | Mean | Standard Deviation | Total Mayo Score |
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| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Primary | Percentage of Participants Who Achieved a Clinical Response at Week 12 | Clinical response is defined as a reduction in the Mayo score of at least 3 points and at least a 30% reduction from Baseline, along with either a decrease from Baseline in the rectal bleeding subscore of more than 1 point or a rectal bleeding subscore of 0 or 1. | The Modified Intent-to-Treat (mITT) population included all randomized subjects who received at least one dose of either TSO or placebo. Only mITT subjects with clinical response results at Week 12 are included in this analysis. | Posted | Number | percentage of participants | Week 12 |
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| Secondary | Percent of Participants Who Achieved Remission at Week 12 | Remission is defined as a Mayo score of less than or equal to 1 with absence of rectal bleeding and endoscopy score of 0 or 1. | The Modified Intent-to-Treat (mITT) population included all randomized subjects who received at least one dose of either TSO or placebo. Only mITT subjects with remission results at Week 12 are included in this analysis. | Posted | Number | percentage of participants | Week 12 |
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| Secondary | Percent of Participants With Healed Colonic Mucosa at Week 12 | Healed colonic mucosa is defined as a Mayo endoscopy score of 0 or 1. | The Modified Intent-to-Treat (mITT) population included all randomized subjects who received at least one dose of either TSO or placebo. Only mITT subjects with a Mayo endoscopy score at Week 12 are included in this analysis. | Posted | Number | percentage of participants | Week 12 |
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| Secondary | Percent of Participants With a Modified Clinical Response | Modified clinical response is defined as a reduction in the modified Mayo score (i.e., minus the endoscopy component) of at least 2 points from baseline. | The Modified Intent-to-Treat (mITT) population included all randomized subjects who received at least one dose of either TSO or placebo. Only mITT subjects with baseline and at least one post-baseline modified clinical response result are included in this analysis. | Posted | Number | percentage of participants | From Day 0 through time of first clinical response or end of follow-up, whichever comes first, up to 12 Weeks |
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| Secondary | Time to Modified Clinical Response | Number of days to reach a modified clinical response. Modified clinical response is defined as a reduction in the modified Mayo score (i.e., minus the endoscopy component) of at least 2 points from baseline. | The Modified Intent-to-Treat (mITT) population included all randomized subjects who received at least one dose of either TSO or placebo. Only mITT subjects who achieved a modified clinical response are included in this analysis. | Posted | Median | Full Range | Days | From Baseline through the day that modified clinical response is reached. Week 16 is the last visit that the modified Mayo score is assessed. |
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| Secondary | Percent of Participants With Colonoscopic Evidence of Visible Worm | Stool evaluations for ova and parasites confirmed the absence of T. suis. If evidence suggested a presence of T. suis, a colonoscopy would be performed to confirm invasion with a visible worm. | The Safety population included all subjects for whom study treatment was initiated. | Posted | Number | percentage of participants | From Day 0 through end of follow-up, up to 36 weeks |
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| Secondary | Percent of Participants With Increase in Diarrhea | An increase in diarrhea is defined as an increase in the Mayo Score's Stool Frequency score by at least 1 point from baseline at any time during follow-up. | The Safety population included all subjects for whom study treatment was initiated. | Posted | Number | percentage of participants | From Day 0 through end of follow-up, up to 36 weeks |
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| Secondary | Percent of Participants With Increase in Concurrent Ulcerative Colitis (UC) Medications or New Rescue Medications Added | New or increase in UC medications is defined as a need for dose-escalation of concurrent medications or need for rescue medications to treat UC through Week 16. | The Safety population included all subjects for whom study treatment was initiated. | Posted | Number | percentage of participants | From Day 0 through Week 16 |
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From the time of signed informed consent to the required follow-up time (Week 36) or until 30 days after the participant prematurely withdrew from the study.
CTCAE V4.0
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | TSO 7500 | Participants were randomized to receive six doses of 7500 viable, embryonated Trichuris suis ova (TSO) in liquid suspension orally over a 10-week period. | 0 | 8 | 6 | 8 | ||
| EG001 | Placebo | Participants were randomized to receive six doses of placebo in liquid suspension orally over a 10-week period. | 0 | 7 | 4 | 7 |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Anaemia | Blood and lymphatic system disorders | MedDRA 16.1 | Systematic Assessment |
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| Lymphopenia | Blood and lymphatic system disorders | MedDRA 16.1 | Systematic Assessment |
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| Abdominal pain | Gastrointestinal disorders | MedDRA 16.1 | Systematic Assessment |
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| Diarrhoea | Gastrointestinal disorders | MedDRA 16.1 | Systematic Assessment |
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| Nausea | Gastrointestinal disorders | MedDRA 16.1 | Systematic Assessment |
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| Stomatitis | Gastrointestinal disorders | MedDRA 16.1 | Systematic Assessment |
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| Condition aggravated | General disorders | MedDRA 16.1 | Systematic Assessment |
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| Fatigue | General disorders | MedDRA 16.1 | Systematic Assessment |
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| Influenza like illness | General disorders | MedDRA 16.1 | Systematic Assessment |
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| Pyrexia | General disorders | MedDRA 16.1 | Systematic Assessment |
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| Clostridium difficile infection | Infections and infestations | MedDRA 16.1 | Systematic Assessment |
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| Pharyngitis streptococcal | Infections and infestations | MedDRA 16.1 | Systematic Assessment |
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| Headache | Nervous system disorders | MedDRA 16.1 | Systematic Assessment |
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| Urinary tract pain | Renal and urinary disorders | MedDRA 16.1 | Systematic Assessment |
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| Cough | Respiratory, thoracic and mediastinal disorders | MedDRA 16.1 | Systematic Assessment |
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| Nasal congestion | Respiratory, thoracic and mediastinal disorders | MedDRA 16.1 | Systematic Assessment |
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| Rales | Respiratory, thoracic and mediastinal disorders | MedDRA 16.1 | Systematic Assessment |
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| Macule | Skin and subcutaneous tissue disorders | MedDRA 16.1 | Systematic Assessment |
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Recruitment was slower than anticipated. The study was ultimately terminated when the manufacturer decided to discontinue study product production.
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Director, Clinical Research Operations Program | DAIT/NIAID | 301-594-7669 | DAITClinicalTrialsGov@niaid.nih.gov |
| ID | Term |
|---|---|
| D003093 | Colitis, Ulcerative |
| D015212 | Inflammatory Bowel Diseases |
| ID | Term |
|---|---|
| D003092 | Colitis |
| D005759 | Gastroenteritis |
| D005767 | Gastrointestinal Diseases |
| D004066 | Digestive System Diseases |
| D003108 | Colonic Diseases |
| D007410 | Intestinal Diseases |
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| Male |
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| Not Hispanic or Latino |
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| Unknown or Not Reported |
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| Asian |
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| Native Hawaiian or Other Pacific Islander |
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| Black or African American |
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| White |
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| More than one race |
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| Unknown or Not Reported |
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