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Clostridium InfectionsPhase 2NCT00350298

Study of the Clinical Effectiveness of a Human Monoclonal Antibody to C. Difficile Toxin A and Toxin B in Patients With Clostridium Difficile Associated Disease

A Phase 2 study testing GS-CDA1/MDX-1388 and normal saline in people with Clostridium Infections, run by MassBiologics at 29 sites in 2 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Patients with Clostridium difficile associated disease who fulfill the eligibility criteria will be approached to participate. All study patients must receive standard of care treatment for Clostridium difficile associated disease. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Clostridium Infections
What is being tested?
GS-CDA1/MDX-1388 and normal saline
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
200 participants
Where
29 sitesin 2 countries
Study dates
20 Jul 2006to 25 Jun 2008
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patient > 18 years of age with diarrhea associated with a positive stool test for C. difficile toxin(s). Patients may be diagnosed with C. difficile by hospital/clinic/reference microbiology laboratory test or by a rapid diagnostic test performed by the study staff and positive test result must be within 14 days of enrollment.
  • Patient must receive standard of care treatment for C. difficile associated disease. Standard of care treatment should include either metronidazole by mouth or intravenously or vancomycin by mouth.
  • Patient or legal representative must have read, understood, and provided written informed consent and Health Insurance Portability and Accountability Act (HIPAA) authorization after the nature of the study has been fully explained.

Who cannot join

  • History of chronic diarrheal illness such as ulcerative colitis or Crohn's disease.
  • Score of 4 on modified Horn's index
  • Severe C. difficile colitis with planned surgery in less than 24 hours.
  • Positive pregnancy test within 24 hours of study infusion or an unwillingness to undergo pregnancy testing in females of child-bearing potential. Females capable of child-bearing must agree not to become pregnant from the time of study enrollment until at least 3 months after completion of study infusion. If a woman is sexually active and has no history of hysterectomy or tubal ligation, she must agree to use hormonal or barrier birth control with spermicidal gel.
  • Breastfeeding.
  • Receipt of other investigational study agent within previous 30 days.
  • Any other condition that in the opinion of the investigator would jeopardize the safety or rights of the patient participating in the study or make it unlikely the patient could complete the study.

Trial locations and contacts

29 sites in 2 countries.

29 sites in 2 countries

United States22 sites
  • Summa Health System

    Akron, Ohio, 44304

  • Central Indiana Gastroenterology Group

    Anderson, Indiana, 46016

  • Saint James Healthcare

    Butte, Montana, 59701

  • Remington-Davis Clinical Research

    Columbus, Ohio, 43214

  • Chest, Infectious Diseases and Critical Care Assoc., PC

    Des Moines, Iowa, 50325

  • St. Lukes Episcopal Hospital

    Houston, Texas, 77030

  • Idaho Falls Infectious Diseases, PLLC

    Idaho Falls, Idaho, 83404

  • Saint Luke's Hospital of Kansas City

    Kansas City, Missouri, 64111

  • University of Kentucky Medical Center

    Lexington, Kentucky, 40536

  • LAC/USC Medical Center

    Los Angeles, California, 90033

  • UCLA CURE Digestive Diseases Center

    Los Angeles, California, 90095

  • Jersey Shore University Medical Center

    Neptune City, New Jersey, 07754

  • Mount Sinai Hospital

    New York, New York, 10029

  • Christiana Care Health Systems

    Newark, Delaware, 19718

  • Kaiser Permanente Vaccine Study Center

    Oakland, California, 94612

  • Rapid City Regional Hospital

    Rapid City, South Dakota, 57701

  • Mayo Clinic

    Rochester, Minnesota, 55905

  • MultiCare Health System Research Services

    Tacoma, Washington, 98405

  • Dr. Kiran C. Patel Research Institute

    Tampa, Florida, 33613

  • Scott and White Memorial Hospital

    Temple, Texas, 76508

  • Henry Ford Health System

    West Bloomfield, Michigan, 48322

  • All-Trials Clinical Research, LLC

    Winston-Salem, North Carolina, 27103

Other trials in United States

Canada7 sites
  • University of Calgary Foothills Medical Center

    Calgary, Alberta, T2N 2T9

  • Centre de Sante et Services Sociaux de Chicoutimi

    Chicoutimi, Quebec, G7H 5H6

  • Kingston General Hospital

    Kingston, Ontario, K7L 2V7

  • Centre Hospitalier Regional de Trois-Rivieres

    Trois-Rivières, Quebec, G8Z 3R9

  • Vancouver Island Health Research Centre

    Victoria, British Columbia, V8R 1J8

  • Windsor Regional Hospital

    Windsor, Ontario, N8W 1L9

  • Health Sciences Centre, University of Manitoba

    Winnepeg, Manitoba, R3A 1R9

Other trials in Canada

About this study

Official title: A Phase II Randomized, Double-Blind, Placebo-Controlled Study of the Clinical Effectiveness of a Human Monoclonal Antibody to Clostridium Difficile Toxin A (GS-CDA1) and a Human Monoclonal Antibody to Clostridium Difficile Toxin B (MDX-1388) in Patients Being Treated for Clostridium Difficile Associated Disease

Patients with Clostridium difficile associated disease who fulfill the eligibility criteria will be approached to participate. All study patients must receive standard of care treatment for Clostridium difficile associated disease. Enrolled patients will be randomized to receive a single intravenous solution of a human monoclonal antibody (huMab) to C. difficile toxin A (GS-CDA1) combined with a human monoclonal antibody to C. difficile toxin B (MDX-1388) or 0.9% sodium chloride as placebo in a 1:1 treatment allocation. Patients will be evaluated for safety and clinical outcomes through day 84 +/- 10 days. Occurrence of adverse events, use of concomitant medications, and stool output will be assessed at scheduled phone contacts and study visits. Some patients enrolled will have a subsequent visit on day 168 ± 14 days.

Read the detailed description

This study is a phase II, randomized, double-blind, placebo-controlled study in patients diagnosed with Clostridium difficile associated disease. Patients with Clostridium difficile associated disease will be identified either from stool test results or by physician referral, and those who fulfill the eligibility criteria will be approached to participate. All study patients must receive standard of care treatment for Clostridium difficile associated disease. Enrolled patients will be randomized to receive a single intravenous solution of a human monoclonal antibody to C. difficile toxin A (GS-CDA1) combined with a human monoclonal antibody to C. difficile toxin B (MDX-1388) or 0.9% sodium chloride as placebo in a 1:1 treatment allocation. One hundred patients will be enrolled in the combination monoclonal antibody treated arm and 100 patients will be enrolled in the placebo arm. Patients will be evaluated through day 84 ± 10 days after receipt of study infusion for safety and clinical outcomes. Blood samples for safety analyses, anti-toxin A and anti-toxin B antibody measurements and human anti-human antibody (HAHA) titers will be collected at scheduled times. Study visits will occur on days 3 ± 1, 10 ± 2, 28 ± 3, 56 ± 7 and on day 84 ± 10 days. Occurrence of adverse events, use of concomitant medications, and record of stool output will be assessed at scheduled phone contacts and study visits. The first 20 patients enrolled will have a subsequent visit on day 168 ± 14 days for an additional blood collection for HAHA analysis.

Being tested
GS-CDA1/MDX-1388, normal saline
Keywords
Monoclonal antibody,, Clostridium difficile Associated Diarrhea
Medical subject headings
Clostridium Infections

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • GS-CDA1/MDX-1388Biological

    One Intravenous dose

  • normal salineBiological

    One Intravenous dose

Study groups in NCT00350298
Study groupRoleWhat they receive
GS-CDA1/MDX-1388ExperimentalBiological: GS-CDA1/MDX-1388 One Intravenous dose
Receives: Biological: GS-CDA1/MDX-1388
PlaceboPlacebo comparatorBiological: normal saline (0.9% sodium chloride) One Intravenous dose
Receives: Biological: normal saline

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of Participants With Recurrence of Clostridium Difficile Associated Disease (CDAD)

    Determine if the addition of C. difficile toxin A and toxin B human monoclonal anti-toxin antibodies to standard of care treatment reduces the number of subjects with recurrent CDAD compared to standard of care and placebo. Standard of care treatment is defined as receipt of either metronidazole by mouth or parenterally or receipt of vancomycin by mouth with a standard duration of treatment defined as 10 - 14 days (+ 2 days)). Recurrence of CDAD is defined as the development of a new episode of C. difficile disease associated with a positive C. difficile stool toxin(s) test after the resolution of prior episode and after discontinuation of SOC treatment.

    Measured: Day 0 to Day 84

Secondary outcomes (5)
  1. Safety and Tolerability of Study Treatment by the Number of Adverse Events Reported

    Safety and tolerability of a C. difficile toxin A human monoclonal antibody combined with a human monoclonal antibody to C. difficile toxin B in patients receiving standard of care treatment for C. difficile associated disease (CDAD) compared to those patients receiving standard of care and placebo reporting system organ class (SOC) MedDRA V.9.0

    Measured: Day 0 to Day 84

  2. Time to Resolution of Initial CDAD Episode

    Determine if the addition of a C. difficile toxin A human monoclonal antibody combined with C. difficile toxin B human monoclonal antibody to standard of care treatment reduces the time to resolution of diarrhea in patients with CDAD compared to those patients receiving standard of care and placebo. Resolution of CDAD is defined as the cessation of diarrhea for at least two consecutive days.

    Measured: Day 0 to Day 84

  3. Number of Patients With Standard of Care Treatment Failure

    Determine if the addition of a C. difficile toxin A human monoclonal antibody combined with C. difficile toxin B human monoclonal antibody to standard of care treatment reduces the number of patients who experience standard of care treatment failure compared to those patients receiving standard of care and placebo. Standard of care treatment failure is defined as (i) recurrence of diarrhea (after it had initially resolved) while on SOC treatment during the first 14 days, or (ii) change in SOC treatment (i.e., antibiotics given), or (iii) diarrhea episode lasting ≥14 days while on SOC treatment.

    Measured: Day 0 to Day 84

  4. Number of Patients With Severe Initial C. Difficile Disease

    Determine if the addition of a C. difficile toxin A human monoclonal antibody combined with C. difficile toxin B human monoclonal antibody to standard of care treatment reduces the number of patients with severe C. difficile disease compared to those patients receiving standard of care and placebo. Severe initial disease is defined as ≥ 5 unformed stools/day for 2 consecutive days from day 1 to the end of the initial episode of diarrhea and discontinuation of SOC.

    Measured: Day 0 to Day 84

  5. Antibody Concentrations to Toxin A and to Toxin B Between Treatment Groups

    Antibody concentrations to Toxin A and to Toxin B in those patients receiving C. difficile toxin A human monoclonal antibody combined with C. difficile toxin B human monoclonal antibody and standard of care treatment to those patients receiving standard of care and placebo

    Measured: Day 0 to Day 84

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted10 Jul 2006 (estimated)
  2. Study start20 Jul 2006
  3. Primary completion25 Jun 2008
  4. Study completion25 Jun 2008

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
200 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00350298
Sponsor's protocol ID
CA-GCDX-06-02
Status last verified
Jan 2021
First submitted
7 Jul 2006
Last updated
9 Feb 2021
Data monitoring committee
Yes

Publications

  • Montgomery DL, Matthews RP, Yee KL, Tobias LM, Dorr MB, Wrishko RE. Assessment of Bezlotoxumab Immunogenicity. Clin Pharmacol Drug Dev. 2020 Apr;9(3):330-340. doi: 10.1002/cpdd.729. Epub 2019 Aug 14.

    PubMed 31411386
  • Gupta SB, Mehta V, Dubberke ER, Zhao X, Dorr MB, Guris D, Molrine D, Leney M, Miller M, Dupin M, Mast TC. Antibodies to Toxin B Are Protective Against Clostridium difficile Infection Recurrence. Clin Infect Dis. 2016 Sep 15;63(6):730-734. doi: 10.1093/cid/ciw364. Epub 2016 Jun 30.

    PubMed 27365387
  • Lowy I, Molrine DC, Leav BA, Blair BM, Baxter R, Gerding DN, Nichol G, Thomas WD Jr, Leney M, Sloan S, Hay CA, Ambrosino DM. Treatment with monoclonal antibodies against Clostridium difficile toxins. N Engl J Med. 2010 Jan 21;362(3):197-205. doi: 10.1056/NEJMoa0907635.

    PubMed 20089970

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing GS-CDA1/MDX-1388 and normal saline in people with Clostridium Infections, run by MassBiologics at 29 sites in 2 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 9 Feb 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 29 sites in United States, Canada. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 9 Feb 2021). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Number of Participants With Recurrence of Clostridium Difficile Associated Disease (CDAD) (time frame: Day 0 to Day 84). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00350298, which also lists 3 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 9 Feb 2021.

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