Crohn's DiseasePhase 1NCT01051622
PBMC (Peripheral Blood Mononuclear Cells) /Lymphocyte SPECT (Single Photon Emission Computerized Tomography) Imaging in Crohn's Disease
A Phase 1 study testing Labeling Ceretec in people with Crohn's Disease, run by GlaxoSmithKline at 2 sites in 2 countries.
Trial summary
Using scintigraphic imaging including planar scintigraphy and SPECT, this study will evaluate the utility of two different ex vivo 99mTc-HMPAO labelled mononuclear cell populations in order to select the optimal methodology (using PBMC or purified lymphocyte subpopulations) for future drug intervention studies in… Read more about this study
- Who is it for?
- Ages 18 years and olderHealthy volunteers can take part
- Conditions the study is for
- Crohn's Disease
- What is being tested?
- Labeling Ceretec
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 13 participants
- Where
- 2 sitesin 2 countries
- Study dates
- Jan 2010to Feb 2011
- Phase
- Phase 1
- Are there results?
- None posted in the registry
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
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- A subject will be eligible for inclusion in this study only if all of the following criteria apply:
- Part A only:
- Healthy as determined by a responsible and experienced physician, based on a medical evaluation including medical history, physical examination, vital signs, ECG, complete blood count and clinical chemistry. A subject with a clinical abnormality or laboratory parameters outside the reference range for the population being studied may be included only if the investigator and the GSK Medical Monitor agree that the finding is unlikely to introduce additional risk factors and will not interfere with the study procedures.
- Part A and B:
- Male or female over 18 years of age inclusive, at the time of signing the informed consent.
- A female subject is eligible to participate if she is of:
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- Non-childbearing potential defined as pre-menopausal females with a documented tubal ligation or hysterectomy; or postmenopausal defined as 12 months of spontaneous amenorrhea [in questionable cases a blood sample with simultaneous follicle stimulating hormone (FSH) > 40 MlU/ml and estradiol < 40 pg/ml (<140 pmol/L) is confirmatory]. Females on hormone replacement therapy (HRT) and whose menopausal status is in doubt will be required to use one of the contraception methods in Section 8.1 if they wish to continue their HRT during the study. Otherwise, they must discontinue HRT to allow confirmation of post-menopausal status prior to study enrollment. For most forms of HRT, at least 2-4 weeks will elapse between the cessation of therapy and the blood draw; this interval depends on the type and dosage of HRT. Following confirmation of their post-menopausal status, they can resume use of HRT during the study without use of a contraceptive method.
- Part B only:
- A history of CD for at least 3 months with a diagnosis confirmed by radiologic, endoscopic or histological assessment.
- Moderate to severe CD as evidenced by an elevated retrospective CDAI score (of
- ≥150) and 1 or more of the following:
- CRP (of ≥5 mg/L); or
- recent (within 4 weeks before the screening visit) evidence of active CD by CT scan, MRI scan or endoscopy. Scans must be part of the patients routine care and should not be conducted as a screening test for this study.
- Radiographic (barium, CT, MRI) or endoscopic evidence of small bowel involvement (if a patient has had a surgical intervention, evidence of small bowel involvement must have been obtained after the procedure).
Who cannot join
- A subject will not be eligible for inclusion in this study if any of the following criteria apply:
- Part A and B:
- Known or positive infection with hepatitis B, hepatitis C or HIV.
- The subject has participated in a clinical trial and has received an investigational product within the following time period prior to Day 1 of the current study: 30 days, 5 half-lives or twice the duration of the biological effect of the investigational product (whichever is longer).
- Previous inclusion in a research and/or medical protocol involving nuclear medicine, PET or radiological investigations with significant radiation burden (a significant radiation burden being defined as ICRP category IIb or above: no more than 10 mSv in addition to natural background radiation, in the previous 3 years including the dose from this study).
- Part B only:
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- Patients with active Crohn's disease with small bowel involvement who are not yet receiving treatment for whom it is judged inappropriate to defer initiating steroid or other treatment for up to 13 days (the maximum interval from screening to last imaging session).
- Patients who are corticosteroid dependent for whom it is judged inappropriate to defer increasing the dose of steroids or initiating other treatment for up to 13 days (the maximum interval from screening to last imaging session).
- Patients who are refractory to steroids or immunosuppressants or anti-TNFs for whom it is judged inappropriate to defer change of medical management or surgical intervention for up to 13 days (the maximum interval from screening to last imaging session).
- The subject is taking >20mg/day Prednisolone or a prednisolone equivalent during the 4 weeks prior to screening
- The subject received treatment natalizumab within 12 weeks prior to study entry;
- The subject has Hb<10 g/l or Lymphocyte count <10^9 /l
- Known C. difficile infection, or a clinical suspicion of a pathogenic bowel infection (including significant infection due to fistula).
- Suspected or diagnosed intra-abdominal abscess or bowel perforation
- The subjects has had bowel surgery (other than appendectomy) within 12 weeks prior to randomization or is likely to require abdominal surgery within 1 month of screening
- Concurrent illness, infection or disability (including malignancies or neoplastic disease of the bowel) that may affect the interpretation of clinical data, or otherwise contraindicates participation in this clinical study (e.g., an unstable cardiovascular, autoimmune, renal, hepatic, pulmonary, endocrine, metabolic, gastrointestinal, hematologic, psychiatric or neurological condition).
Trial locations and contacts
2 sites in 2 countries.
2 sites in 2 countries
About this study
Official title: An Exploratory SPECT Imaging Study to Assess the Utility of High-specific Activity 99mTc-HMPAO Labeling as a Tool to Detect PBMC and Lymphocyte Trafficking in the Small Bowel or Ileo-caecal Region of Crohn's Disease Patients
Using scintigraphic imaging including planar scintigraphy and SPECT, this study will evaluate the utility of two different ex vivo 99mTc-HMPAO labelled mononuclear cell populations in order to select the optimal methodology (using PBMC or purified lymphocyte subpopulations) for future drug intervention studies in Crohn's disease.
Two parallel exploratory approaches will be investigated to enrich for lymphocyte populations expressing leukocyte trafficking inhibitors. In the first, whole blood will be fractionated on a ficoll gradient to purify a heterogeneous population of all the peripheral blood mononuclear cells (PBMC) for labelling. Secondly, further enrichment will be attempted using depletion of PBMC fractions of monocytes and B cells.
Read the detailed description
This study is based on the established technology of scintigraphic 'white cell scanning', in which the leukocytes in a limited volume of patient's blood are radiolabeled with indium-111 or technetium-99m, re-introduced into the circulation, and their subsequent trafficking and accumulation in areas of active inflammation is visualised by scintigraphic imaging. This methodology is routinely used for diagnosis of inflammatory conditions and pharmacodynamic changes have been documented in the literature. As it is intended that this technology could be used in future drug intervention studies.
However, because this sub-population labelling methodology remains exploratory, this study will investigate the utility of such techniques for use in future clinical trials in Crohn's patients.
Two parallel exploratory approaches will be investigated to enrich for lymphocyte populations expressing leukocyte trafficking inhibitors. In the first, whole blood will be fractionated on a ficoll gradient to purify a heterogeneous population of all the peripheral blood mononuclear cells (PBMC) for labelling. Secondly, T lymphocytes will be further enriched by depletion of monocytes and B cells from PBMC fractions. In part A one scintigraphy scan will be performed in healthy volunteers to confirm that the purification and labelling procedure does not show abnormal biodistribution compared to the known physiological distribution of labelled mononuclear cells [Bennink, 2008].
In part B, Crohn's disease patients will then be recruited to undergo two scintigraphy scans 48-72 hours apart to establish intra-patient variability and feasibility of the repeated procedure that will be used in subsequent studies for therapeutic intervention. Analysis of SPECT images will be performed using a standardized scoring system.
- Conditions
- Crohn's Disease
- Being tested
- Labeling Ceretec
- Keywords
- PBMC (Peripheral Blood Mononuclear Cells), Crohn's Disease, SPECT (Single Photon Emission Computerized Tomography)
- Medical subject headings
- Crohn Disease
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Labeling CeretecOther
Technetium-99m is used to radiolabel cells of interest i.e PBMC's
| Study group | Role | What they receive |
|---|---|---|
| PBMC Trafficking | Experimental | In part B, Patients undergo a blood draw (up to150 mL) and the PBMC's are separated and selected or 99mTc-HMPAO labeling. The purified and labelled cells will be re-introduced into the patient by intravenous infusion and one SPECT scan and up to 8 serial planar scintigraphy scans will initially be conducted over up to 6 hours within 1 scan session. All suitable patients showing evidence of cellular uptake in the ileo-caecal region and/or small bowel at Visit 1 will be progressed to an identical second cell labeling and scanning session at Visit 2 (48 hours later). Subjects showing no evidence of cellular uptake in the ileo-caecal region or small bowel at Visit 1 (negative scan) will be withdrawn from the study and proceed to the follow-up. Receives: Other: Labeling Ceretec |
| T Lymphocyte Trafficking | Experimental | In part B, Patients undergo a blood draw (up to150 mL) and the T lymphocyte cells are separated and selected or 99mTc-HMPAO labeling. The purified and labelled cells will be re-introduced into the patient by intravenous infusion and one SPECT scan and up to 8 serial planar scintigraphy scans will initially be conducted over up to 6 hours within 1 scan session. All suitable patients showing evidence of cellular uptake in the ileo-caecal region and/or small bowel at Visit 1 will be progressed to an identical second cell labeling and scanning session at Visit 2 (48 hours later). Subjects showing no evidence of cellular uptake in the ileo-caecal region or small bowel at Visit 1 (negative scan) will be withdrawn from the study and proceed to the follow-up.
visit. Receives: Other: Labeling Ceretec |
What is being measured
The primary outcome is the main question the study is designed to answer.
Quantification of scintigraphic activity score for small bowel disease (for both PBMC and lymphocyte imaging methodologies)
Measured: 1 day
Secondary outcomes (5)
Tolerability endpoints including AEs
Measured: Up to 3 weeks
Variability and reproducibility of the PBMC and lymphocyte imaging methodologies at visits 1 and 2.
Measured: Up to 3 days
Rate of label accumulation in small bowel
Measured: 1 day
Circulating PBMC and lymphocyte subpopulation cell counts and correlation with scintigraphic activity scores.
Measured: 1 day
Correlation between CDAI, CRP, calprotectin, ASCA antibodies and SAS
Measured: Up to 3 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted18 Jan 2010 (estimated)
- Study startJan 2010
- Primary completionFeb 2011
- Study completionFeb 2011
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Crohn's DiseaseStudies of the same condition, open and under way.
- More trials run by GlaxoSmithKlineThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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 1
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 13 participants (actual)
Sponsor and investigators
- Lead sponsor
- GlaxoSmithKline
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- GSK Clinical Trials, Study director, GlaxoSmithKline
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01051622
- Sponsor's protocol ID
- 113265
- Status last verified
- May 2014
- First submitted
- 3 Dec 2009
- Last updated
- 2 Jun 2014
- Results posted
- No
- Data monitoring committee
- No
Study at a glance
From the registry record, last updated by the sponsor on 2 Jun 2014. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- An Exploratory SPECT Imaging Study to Assess the Utility of High-specific Activity 99mTc-HMPAO Labeling as a Tool to Detect PBMC and Lymphocyte Trafficking in the Small Bowel or Ileo-caecal Region of Crohn's Disease Patients
- ClinicalTrials.gov ID
- NCT01051622
- Acronym / sponsor ID
- 113265
- Conditions
- Crohn's Disease
- Keywords
- PBMC (Peripheral Blood Mononuclear Cells), Crohn's Disease, SPECT (Single Photon Emission Computerized Tomography)
- Phase
- Phase 1
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 13 participants (actual)
- Lead sponsor
- GlaxoSmithKlineIndustry (pharma, biotech, devices)
- Study start
- Jan 2010
- Primary completion
- Feb 2011 (actual)
- Study completion
- Feb 2011 (actual)
- First posted
- 18 Jan 2010 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Using scintigraphic imaging including planar scintigraphy and SPECT, this study will evaluate the utility of two different ex vivo 99mTc-HMPAO labelled mononuclear cell populations in order to select the optimal methodology (using PBMC or purified lymphocyte subpopulations) for future drug intervention studies in Crohn's disease.
Two parallel exploratory approaches will be investigated to enrich for lymphocyte populations expressing leukocyte trafficking inhibitors. In the first, whole blood will be fractionated on a ficoll gradient to purify a heterogeneous population of all the peripheral blood mononuclear cells (PBMC) for labelling. Secondly, further enrichment will be attempted using depletion of PBMC fractions of monocytes and B cells.
Detailed description
This study is based on the established technology of scintigraphic 'white cell scanning', in which the leukocytes in a limited volume of patient's blood are radiolabeled with indium-111 or technetium-99m, re-introduced into the circulation, and their subsequent trafficking and accumulation in areas of active inflammation is visualised by scintigraphic imaging. This methodology is routinely used for diagnosis of inflammatory conditions and pharmacodynamic changes have been documented in the literature. As it is intended that this technology could be used in future drug intervention studies.
However, because this sub-population labelling methodology remains exploratory, this study will investigate the utility of such techniques for use in future clinical trials in Crohn's patients.
Two parallel exploratory approaches will be investigated to enrich for lymphocyte populations expressing leukocyte trafficking inhibitors. In the first, whole blood will be fractionated on a ficoll gradient to purify a heterogeneous population of all the peripheral blood mononuclear cells (PBMC) for labelling. Secondly, T lymphocytes will be further enriched by depletion of monocytes and B cells from PBMC fractions. In part A one scintigraphy scan will be performed in healthy volunteers to confirm that the purification and labelling procedure does not show abnormal biodistribution compared to the known physiological distribution of labelled mononuclear cells [Bennink, 2008].
In part B, Crohn's disease patients will then be recruited to undergo two scintigraphy scans 48-72 hours apart to establish intra-patient variability and feasibility of the repeated procedure that will be used in subsequent studies for therapeutic intervention. Analysis of SPECT images will be performed using a standardized scoring system.
Study design
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| PBMC Trafficking | Experimental | Other: Labeling CeretecIn part B, Patients undergo a blood draw (up to150 mL) and the PBMC's are separated and selected or 99mTc-HMPAO labeling. The purified and labelled cells will be re-introduced into the patient by intravenous infusion and one SPECT scan and up to 8 serial planar scintigraphy scans will initially be conducted over up to 6 hours within 1 scan session. All suitable patients showing evidence of cellular uptake in the ileo-caecal region and/or small bowel at Visit 1 will be progressed to an identical second cell labeling and scanning session at Visit 2 (48 hours later). Subjects showing no evidence of cellular uptake in the ileo-caecal region or small bowel at Visit 1 (negative scan) will be withdrawn from the study and proceed to the follow-up. |
| T Lymphocyte Trafficking | Experimental | Other: Labeling CeretecIn part B, Patients undergo a blood draw (up to150 mL) and the T lymphocyte cells are separated and selected or 99mTc-HMPAO labeling. The purified and labelled cells will be re-introduced into the patient by intravenous infusion and one SPECT scan and up to 8 serial planar scintigraphy scans will initially be conducted over up to 6 hours within 1 scan session. All suitable patients showing evidence of cellular uptake in the ileo-caecal region and/or small bowel at Visit 1 will be progressed to an identical second cell labeling and scanning session at Visit 2 (48 hours later). Subjects showing no evidence of cellular uptake in the ileo-caecal region or small bowel at Visit 1 (negative scan) will be withdrawn from the study and proceed to the follow-up. visit. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (14 listed)
- A subject will be eligible for inclusion in this study only if all of the following criteria apply:
- Healthy as determined by a responsible and experienced physician, based on a medical evaluation including medical history, physical examination, vital signs, ECG, complete blood count and clinical chemistry. A subject with a clinical abnormality or laboratory parameters outside the reference range for the population being studied may be included only if the investigator and the GSK Medical Monitor agree that the finding is unlikely to introduce additional risk factors and will not interfere with the study procedures.
- Male or female over 18 years of age inclusive, at the time of signing the informed consent.
- A female subject is eligible to participate if she is of:
- A history of CD for at least 3 months with a diagnosis confirmed by radiologic, endoscopic or histological assessment.
Key exclusion criteria (16 listed)
- A subject will not be eligible for inclusion in this study if any of the following criteria apply:
- Known or positive infection with hepatitis B, hepatitis C or HIV.
- The subject has participated in a clinical trial and has received an investigational product within the following time period prior to Day 1 of the current study: 30 days, 5 half-lives or twice the duration of the biological effect of the investigational product (whichever is longer).
- Previous inclusion in a research and/or medical protocol involving nuclear medicine, PET or radiological investigations with significant radiation burden (a significant radiation burden being defined as ICRP category IIb or above: no more than 10 mSv in addition to natural background radiation, in the previous 3 years including the dose from this study).
- Patients with active Crohn's disease with small bowel involvement who are not yet receiving treatment for whom it is judged inappropriate to defer initiating steroid or other treatment for up to 13 days (the maximum interval from screening to last imaging session).
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Labeling CeretecTechnetium-99m is used to radiolabel cells of interest i.e PBMC's | Other | PBMC Trafficking, T Lymphocyte Trafficking |
Primary outcome
Quantification of scintigraphic activity score for small bowel disease (for both PBMC and lymphocyte imaging methodologies)
Time frame: 1 day
5 secondary outcomes
Tolerability endpoints including AEs
Time frame: Up to 3 weeks
Variability and reproducibility of the PBMC and lymphocyte imaging methodologies at visits 1 and 2.
Time frame: Up to 3 days
Rate of label accumulation in small bowel
Time frame: 1 day
Circulating PBMC and lymphocyte subpopulation cell counts and correlation with scintigraphic activity scores.
Time frame: 1 day
Correlation between CDAI, CRP, calprotectin, ASCA antibodies and SAS
Time frame: Up to 3 weeks
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 2 Jun 2014.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
GSK Clinical Trials study director
GlaxoSmithKline
2 sites in 2 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 1 study testing Labeling Ceretec in people with Crohn's Disease, run by GlaxoSmithKline at 2 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 14 inclusion and 16 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 2 Jun 2014. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 2 sites in Belgium, Netherlands. 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. 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 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
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?
Quantification of scintigraphic activity score for small bowel disease (for both PBMC and lymphocyte imaging methodologies) (time frame: 1 day). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 2 Jun 2014.