The primary objective is to determine the efficacy (as measured by pulmonaryfunction) and safety of CNTO 888 in subjects with IPF. The major secondary objectives are to assess theeffect of CNTO 888 on measures of disease progression, to assess theā¦
ID
Source
Brief title
Condition
- Pleural disorders
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
The primary endpoint of this study is the rate of percent change (relative to
baseline per 4-week interval) in FVC through Week 52.
Secondary outcome
The major secondary endpoints include:
* Time to disease progression (defined as the time from randomization to
occurrence of 1 of the
following events, whichever occurs first: acute IPF exacerbation, lung
transplantation, and/or all cause
mortality) through Week 52.
* Absolute change from baseline in FVC (mL) at Week 52.
* Relative change from baseline in DLCO at Week 52.
* Change from baseline in St. George*s Respiratory Questionnaire total score at
Week 52.
Background summary
In vitro and in vivo research confirms the hypothesis that CCL2 plays een
important role in fibrosis. CNTO 888( Anti-CCL2 monoclonal antibody) can be an
effective agent for the treatment of IPF by neutralizing the profibrotic
activity of CCL2.
Study objective
The primary objective is to determine the efficacy (as measured by pulmonary
function) and safety of CNTO 888 in subjects with IPF. The major secondary
objectives are to assess the
effect of CNTO 888 on measures of disease progression, to assess the effect of
CNTO 888 on patient
reported outcomes, functional capacity measurements, and health-related quality
of life in subjects with
IPF, and to assess the pharmacokinetics and pharmacodynamics of CNTO 888 in
subjects with IPF.
Study design
This is a Phase 2, multicenter, multinational, randomized, double-blind
placebo-controlled, parallel-group, dose-ranging study in subjects with IPF.
Intervention
Subjects will be randomly assigned to 1 of 4 treatment groups in a 1:1:1:1
ratio. Subject allocation to treatment group will be performed using a permuted
block randomization
stratified with the following strata: (1) high-risk category (yes/no), and (2)
baseline oral corticosteroid
use (yes/no).
Group 1 (n = 30): Placebo intravenous (IV) infusion every 4 weeks (q4w), from
Week 0 through
Week 48.
Group 2 (n = 30): CNTO 888 1 mg/kg IV infusion q4w, from Week 0 through Week 48.
Group 3 (n = 30): CNTO 888 5 mg/kg IV infusion q4w, from Week 0 through Week 48.
Group 4 (n = 30): CNTO 888 15 mg/kg IV infusion q4w, from Week 0 through Week 48
The study will enroll and treat the first 20 subjects (with 3 doses of study
agent), as part of a safety
run-in, in a subset of sites. These subjects will be randomized in a 1:1:1:1
ratio to placebo, 1 mg/kg,
5 mg/kg, or 15 mg/kg CNTO 888. A formal Data Monitoring Committee (DMC) review
will occur
following this safety run-in, and will recommend whether or not enrollment may
be opened up to the rest
of the sites.
Route of Administration: IV infusion
Interval Between First and Last Dose of Active Study Agent: 48 weeks
Duration of Study Participation: All subjects will be followed through Week 72,
even if the study
drug treatment is prematurely discontinued for any reason.
End of Study Definition: The end of the study is defined as the last visit of
the last subject worldwide.
Number of Subjects: Approximately 120 subjects with IPF will be randomly
assigned in a 1:1:1:1 ratio
to 1 of the 4 treatment groups, resulting in approximately 30 subjects in each
of the 3 active CNTO 888
treatment groups and 30 in the placebo group.
Number of Sites: Approximately 25 sites globally.
Study burden and risks
The patient receives the following examinations:
- Physical examination
- Tuberculosis evaluation including X-ray if nessecary
- DLCO test, if not available within 3 months before the screening visit
- Blooddraw
- Questionnaires
- 'Exhaled Breath Condensate' (EBC) test
- Urine sample
- '6 minute walk test'
- Pulmonary function test
- 'High resolution computed tomography' (HRCT) scan
- Studyagent administration
Possible side-effects of the studyagent could be:
Hypersensitivity, immune response to antibodies, risk of bleeding, exposure to
radiation, risk of unknown side-effects of CNTO 888
Despite current treatment IPF remains a progressive, irreversibel and
life-threathening disease.
The scientific rationale for anti-CCL2 therapy in the treatment of idiopathic
pulmonary fibrosis supports the development of CNTO 888 for this indication.
Evaluation of the safety and efficacy of CNTO 888 in the treatment of subjects
with idiopathic pulmonary fibrosis is reasonable based on evaluation of the
benefits versus the risks observed in the preclinical studies and current data
from the first in human Phase 1 oncology study. CNTO 888 may provide an
effective treatment for patients with idiopathic pulmonary fibrosis while also
providing an acceptable risk / benefit ratio.
Dr Paul Janssenweg 150
5026 RH Tilburg
NL
Dr Paul Janssenweg 150
5026 RH Tilburg
NL
Listed location countries
Age
Inclusion criteria
1. Aged 40 to 80, inclusive.
a. Subjects who are aged 40 years to < 50 years of age at the time of screening
will be required to have surgical lung biopsy evidence of UIP in order to be
considered eligible for the trial.
2. Physician diagnosis of IPF (according to a modified version of the ATS/ERS
criteria; ATS, 2000) within 4 years of screening.
Subjects must meet all of the major criteria and 3 of the 4 minor criteria listed
below:
Major criteria (must meet all)
a. Exclusion of other known causes of interstitial lung disease, such as certain
drug toxicities, environmental exposures, and connective tissue diseases.
b. Abnormal pulmonary function studies that include evidence of restriction
(reduced vital capacity, often with an increased FEV1/FVC ratio) and
impaired gas exchange (increased alveolar-arterial oxygen gradient
[P(A-a)O2] or evidence of desaturation at rest or exercise or decreased
DLCO).
c. Bibasilar reticular abnormalities with minimal ground-glass opacities on
HRCT scans.
Minor Criteria (must meet 3)
a. Age > 50 years.
b. Insidious onset of otherwise unexplained dyspnea on exertion.
c. Duration of illness * 3 months.
d. Bibasilar, inspiratory crackles (dry or *Velcro-type* in quality).
3. Have surgical lung biopsy evidence of UIP and/or HRCT scan-based diagnosis of
IPF. In the absence of surgical lung biopsy, an HRCT scan obtained within
3 months prior to or at screening must be available for review.
4. Have evidence of progressive IPF disease activity despite current treatment.
Progressive IPF disease activity, for the purposes of this protocol, is defined as
having 1 or more of the following within the past 12 months:
a. Relative decrease of * 10% in FVC.
b. Relative decrease of * 15% in DLCO.
c. Evidence of clinically significant worsening on HRCT (eg, development of
honeycombing, increase in opacities).
d. Significant worsening of dyspnea at rest or with exertion.
5. Evidence of recent stability of percent-predicted FVC (defined as not having
changed > 15% at the baseline visit relative to the screening visit).
6. FVC * 50% of the predicted value at screening.
7. Women of childbearing potential must have a negative serum pregnancy test result
at screening. Women of childbearing potential and all men must be using adequate
birth control measures and must agree to continue to use such measures and not become pregnant or plan a pregnancy until 12 months after receiving the last
infusion of study agent.
8. Are considered eligible according to the following TB screening criteria:
a. Have no history of latent or active TB prior to screening.
b. Have no signs or symptoms suggestive of active TB upon medical history
and/or physical examination.
c. Have had no recent close contact with a person with active TB.
d. Within 2 months prior to the first administration of study agent, have
negative diagnostic TB test results (defined as a negative QuantiFERON-TB
Gold test).
e. Have a chest radiograph (both posterior-anterior and lateral views) if
clinically indicated or HRCT taken within 3 months prior to screening and
read by a qualified radiologist, with no clear evidence of current active TB or
old inactive TB.
9. Capable of understanding subject assessment forms.
10. Have provided signed, written, informed consent before receiving any protocol
specific procedures.
11. Willing to adhere to the study visit schedule and other protocol requirements.
Exclusion criteria
1. Have evidence of interstitial pneumonia other than IPF.
2. Diagnosis of IPF is not confirmed by HRCT or lung biopsy results.
3. Partial pressure of oxygen in arterial blood (PaO2) < 55 mmHg (sea level) or
50 mmHg (altitude) at rest on room air. If arterial blood gas results are not
available, an oxygen saturation via pulse oximetry (SpO2) < 88% with O2
supplementation at rest.
4. Known clinically significant pulmonary hypertension requiring vasodilator therapy
(eg, calcium channel blockers, prostacyclin or prostacyclin analogs, nitric oxide,
adenosine) or chronic anticoagulation therapy.
5. Have a diagnosis of other significant respiratory disorder (eg, asthma, TB,
sarcoidosis, aspergillosis, chronic obstructive pulmonary disease [COPD], or cystic
fibrosis).
6. Have obstruction on prebronchodilator PFTs (defined as FEV1/FVC < 0.7) at
screening.
7. Demonstrate an increase in FEV1 * 12% postbronchodilator.
8. Have a predicted life expectancy less than 1 year.
9. Previous treatment for IPF with an investigational/experimental medication within
6 weeks, or within 5 t1/2 of the investigational/experimental medication, whichever
is longer, prior to screening or are participating in another investigative study.
10. Current treatment with sildenafil, IFN-*, mycophenolate, or endothelin receptor
antagonists.
11. Current signs or symptoms of severe, progressive, or uncontrolled renal, hepatic,
hematologic, gastrointestinal, endocrine, cardiac, neurologic, or cerebral disease, or
any laboratory abnormality which would pose/suggest a risk to the subject by
participation in the study.
12. Known to be seropositive for HIV, known active hepatitis A, B, or C infection, or
ALT/SGPT and/or AST/SGOT > 2 times the upper limit of normal at screening.
13. Within 3 months prior to screening, have had a clinically important, serious
infection (eg, hepatitis, pneumonia, or pyelonephritis), have been hospitalized for
an infection, or have been treated with IV antibiotics for an infection. Less serious
infections (eg, acute upper respiratory tract infection or simple urinary tract
infection) need not be considered exclusions at the discretion of the investigator.
14. Opportunistic infection (eg, cytomegalovirus, Pneumocystis carinii) within
6 months prior to screening.
15. Received any live attenuated vaccination (eg, FluMist) within 3 months prior to
screening or are expected to receive any live attenuated vaccinations during the trial
or up to 3 months after the last administration of study agent. Inactivated,
injectable influenza and pneumococcal vaccines are permissible.
16. Serious concomitant illness that could interfere with the subject*s participation in
the study.
17. History of substance abuse (drugs or alcohol) within the 3 years prior to screening, history of noncompliance to medical regimens, or other condition/circumstance that could interfere with the subject*s adherence to protocol requirements (eg,
psychiatric disease, lack of motivation, travel).
18. Major surgery within 1 month prior to screening or planned surgery during the
study.
19. Currently listed for lung transplantation.
20. Have any known malignancy or have a history of malignancy within the previous
5 years (with the exception of a nonmelanoma skin cancer that has been treated
with no evidence of recurrence for at least 3 months).
21. Have a transplanted organ (with the exception of a corneal transplant > 3 months prior to screening).
22. Known allergies or clinically significant reactions to murine, murine-human
chimeric, or human proteins or other components of the product.
23. Significant bleeding diathesis or excessive risk of bleeding, including chronic
anticoagulant therapy.
Design
Recruitment
Medical products/devices used
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
Register | ID |
---|---|
EudraCT | EUCTR2008-001281-86-NL |
CCMO | NL24850.018.08 |