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Immune ThrombocytopeniaPhase 1/2NCT02566603

PRTX-100-203 Open-Label, Dose Escalation Study in Adult Patients With ITP

A Phase 1/2 study testing PRTX-100 in people with Immune Thrombocytopenia, run by Protalex, Inc. at 16 sites in 2 countries.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

Pre-clinical and clinical evaluations show that PRTX- 100 has biological activity that may lead to improved platelet levels where these are decreased due to immunological pathologies and that PRTX-100 has an acceptable safety profile. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Immune Thrombocytopenia
What is being tested?
PRTX-100
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
15 participants
Where
16 sitesin 2 countries
Study dates
Nov 2015to 17 May 2018
Phase
Phase 1/2
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
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Willing and able to provide written informed consent prior to initiation of any study-related procedures
  • Male or female ≥ 18 years of age
  • ITP that has persisted for ≥ 3 months. ITP must be diagnosed in accordance The American Society of Hematology 2011 Evidence-based Practice Guideline for Immune Thrombocytopenia (Neunert et al. 2011) or the International Consensus Report on The Investigation and Management of Primary Immune Thrombocytopenia (Provan et al. 2010), as locally applicable.
  • Received ≥ 1 typical regimen for the treatment of ITP. Splenectomy is considered one regimen.
  • A mean platelet count of < 30,000/μL with no individual platelet count > 55,000/μL. The mean platelet count must be determined based on 2 platelet counts including one obtained within ≤ 7 days of first PRTX-100 dose and the other within ≤ 30 days of the first dose of PRTX-100.
  • If on corticosteroids, a dose of < 1 mg/kg prednisone per day or equivalent that has been stable for ≥ 21 days prior to the first dose of PRTX-100. High-dose pulse steroid therapy is NOT allowed within 14 days prior to the first dose of PRTX-100.
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  • If on steroid-sparing adjunctive immunosuppression with cyclosporine, azathioprine, mycophenolate, or 6-mercaptopurine, the dose must have been stable for ≥ 30 days prior to the first dose of PRTX-100 and must be expected to remain stable through study Day 29, unless dose reduction is required due to toxicities. Treatment with other cytotoxic agents (e.g. cyclophosphamide, vincristine) are not allowed within three months prior to the first dose of PRTX- 100.
  • Any prior treatment with rituximab or any other anti-CD20 agent must have been > 6 months prior to the first dose of PRTX-100
  • If female, must not be pregnant (as indicated by screening negative pregnancy test), must not be nursing and must be one of the following:
  • Surgically sterile (bilateral tubal ligation, hysterectomy)
  • Postmenopausal with last natural menses > 24 months prior
  • Premenopausal and using an acceptable form of birth control. Acceptable forms of birth control include: hormonal contraceptives (implantable, oral, patch) used for ≥ 2 months prior to screening or double barrier methods (any combination of two of the following: intrauterine device [IUD], male or female condom with spermicidal gel, diaphragm, sponge, cervical cap). All premenopausal females must have a negative urine or serum pregnancy test at screening and on Day 1 prior to first PRTX-100 treatment.

Who cannot join

  • Splenectomy ≤ 90 days prior to the first dose of PRTX-100
  • Exposure to TPO-RA within 2 weeks before inclusion
  • Previous treatment with rituximab within <6 months prior to the first dose of PRTX-100
  • Bleeding score ≥ 8 (Khellaf M et al. Haematologica 2005)
  • Unstable coronary artery disease or other medical condition (such as type 1 diabetes) that, in the investigator's opinion, might increase the risk to the patient
  • Evidence of active infection requiring antibiotic therapy ≤ 14 days prior to the first dose of PRTX-100
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  • Myelodysplastic syndrome. If clinically significant anemia or pancytopenia exists, documentation of a bone marrow aspirate within 24 months prior to the first dose of PRTX- 100 showing no evidence of myelodysplasia is required.
  • Medical history systemic lupus erythematosus or any cause of secondary ITP
  • History of any treatment for cancer within the past two years other than basal cell or squamous cell carcinoma of the skin that has been treated with curative intent
  • Seropositive for human immunodeficiency virus (HIV)
  • History of acute/chronic hepatitis B or C and/or carriers of hepatitis B or C (positive for hepatitis B surface antigen or positive anti-hepatitis C antibody test)
  • History suggestive of substance abuse
  • Clinically significant abnormalities in screening laboratory tests, including:
  • Absolute neutrophil count < 1.0 x109/L
  • Hemoglobin < 10 g/dL
  • Absolute lymphocyte count < 0.8 x109/L
  • Alanine transaminase (ALT) or aspartate transaminase (AST) > 2 x upper limit of normal (ULN)
  • Lactate dehydrogenase > 3 x ULN
  • Total bilirubin level >1.5 x ULN
  • Serum creatinine level > 0.14 mmol/L (1.6 mg/dL) in males or 0.12 mmol/L (1.4 mg/dL) in females
  • Treatment with IVIG ≤ 14 days prior to the first dose of PRTX-100
  • Treatment with an anti-Rh D antigen agent (e.g. WinRho®) ≤ 14 days prior to the first dose of PRTX-100
  • Use of any investigational drug ≤ 30 days or 5 half-lives of the investigational drug (whichever is longer) prior to the first dose of PRTX-100

Trial locations and contacts

16 sites in 2 countries.

16 sites in 2 countries

France9 sites
  • Côte de Nacre Hospital

    Caen, 14033

  • Mondor Hospital

    Créteil, 94010

  • University Hospital

    Dijon, 21000

  • Claude Huriez Hospital

    Lille, 59037

  • CH La Timone

    Marseille, 13385

  • CHU

    Nantes, 44093

  • Haut-Levêque Hospital

    Pessac, Bordeaux, 33600

  • CH Lyon Sud

    Pierre-Bénite, Lyon, 69495

  • Canceropole

    Toulouse, 31059

Other trials in France

United Kingdom7 sites
  • Hammersmith Hospital

    London, OHS, W12

  • UCLH

    London, UK, NW1 2BU

  • Guy's and St. Thomas Hospital

    London, UK, SE 19RT

  • St. Georges' Hospital

    London, UK, SW17 0QT

  • Royal London Hospital

    London

  • Derriford Hospital

    Plymouth, UK, PL6 8DH

  • University Hospital Southampton

    Southampton, UK, SO16 6YD

Other trials in United Kingdom

About this study

Official title: A Phase 1b Open-Label, Dose Escalation Study of PRTX-100 in Adult Patients With Persistent/Chronic Immune Thrombocytopenia

Pre-clinical and clinical evaluations show that PRTX- 100 has biological activity that may lead to improved platelet levels where these are decreased due to immunological pathologies and that PRTX-100 has an acceptable safety profile. In vivo treatment with PRTX-100 has been shown to raise platelet counts in a mouse model of immune thrombocytopenia (ITP). The primary objective of the study is to assess the efficacy of PRTX-100 in terms of platelet response in patients with chronic/persistent ITP.

Being tested
PRTX-100
Keywords
ITP, Thrombocytopenia
Medical subject headings
Purpura, Thrombocytopenic, Idiopathic, Thrombocytopenia

What participants receive

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

  • PRTX-100Drug

    Also called SpA, Staphylococcal Protein A

    Four weekly infusions of PRTX-100 at a level of 3 micrograms of PRTX-100 per kilogram of patient weight, infused over 30 minutes, followed by four hours of observation after start of infusion.

  • PRTX-100Drug

    Also called SpA, Staphylococcal Protein A

    Four weekly infusions of PRTX-100 at a level of 6 micrograms of PRTX-100 per kilogram of patient weight, infused over 30 to 60 minutes, followed by four hours of observation after start of infusion.

  • PRTX-100Drug

    Also called SpA, Staphylococcal Protein A

    Four weekly infusions of PRTX-100 at a level of 12 micrograms of PRTX-100 per kilogram of patient weight, infused over 60 minutes, followed by four hours of observation after start of infusion.

  • PRTX-100Drug

    Also called SpA, Staphylococcal Protein A

    Four weekly infusions of PRTX-100 at a level of 18 micrograms of PRTX-100 per kilogram of patient weight, infused over 60 minutes, followed by four hours of observation after start of infusion.

  • PRTX-100Drug

    Also called SpA, Staphylococcal Protein A

    Four weekly infusions of PRTX-100 at a level of 24 micrograms of PRTX-100 per kilogram of patient weight, infused over 60 minutes, followed by four hours of observation after start of infusion.

Study groups in NCT02566603
Study groupRoleWhat they receive
PRTX-100ExperimentalPatients will be assigned to consecutive PRTX-100 interventions as they are enrolled into the study. Between three and six patients will be enrolled per intervention level. Intervention levels range from 3 to 24 micrograms of PRTX-100 per kilogram of patient weight. Patients may receive up to four weekly infusions of PRTX-100 over the study treatment period. PRTX-100 doses ≤ 500 μg will be infused intravenously over 30 minutes. PRTX-100 doses > 500 μg will be infused over 60 minutes. Patients will remain under observation for 4 hours after initiation of PRTX-100 dosing for safety management.
Receives: Drug: PRTX-100

What is being measured

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

  1. Number of participants with treatment-related adverse events as assessed by Toxicity Grading Criteria based on RCTC v 2.0 and CTCAE v 4.03

    Adverse events from AEs, SAEs, infusion reactions, clinical laboratory tests (hematology, blood chemistry and urinalysis), vital signs, physical findings and ECGs over the course of the study. AE severity will be graded according to Toxicity Grading Criteria derived from published standards.

    Measured: 337 Days

Secondary outcomes (5)
  1. Overall platelet response, change from baseline (Day 1)

    Defined as a platelet count ≥ 30,000/μL and at least a doubling of baseline platelet count in patients with a baseline platelet count <30,000/μL in the absence of any concomitant rescue therapy.

    Measured: Days 1, 3, 8, 15, 22, 29, 36, 43, 50, 78, 106, 169, and 337

  2. Complete platelet response (number of patients)

    The number of patients demonstrating a complete platelet response, defined as a platelet count ≥ 100,000/μL.

    Measured: Days 3, 8, 15, 22, 29, 36, 43, 50, 78, 106, 169, and 337

  3. Time to platelet response (number of days)

    The mean number of days from first PRTX-100 dose (Day 1) until platelet response.

    Measured: Days 3, 8, 15, 22, 29, 36, 43, 50, 78, 106, 169, and 337

  4. Durability of platelet response (number of days)

    The number of days from first documented platelet response to first platelet count below platelet response criteria.

    Measured: Days 3, 8, 15, 22, 29, 36, 43, 50, 78, 106, 169, and 337

  5. Concomitant ITP medication use (number of subjects)

    The number of subjects considered non-responders based on concomitant ITP medication use by cohort and overall. ITP medications include thrombopoietin receptor agonists (TPO-RAs), steroid-sparing adjunctive immunosuppressive treatment (e.g. cyclosporine, azathioprine, mycophenolate), and any ITP rescue medications (e.g. IVIG) received during the study Screening and Treatment Periods.

    Measured: 337 Days

Timeline

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

  1. First posted2 Oct 2015 (estimated)
  2. Study startNov 2015
  3. Primary completion17 May 2018
  4. Study completion17 May 2018

Why it stopped: Enough data has been collected to allow analysis of the safety profile and risk-benefit.

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 1/2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
15 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02566603
Sponsor's protocol ID
PRTX-100-203
Other IDs
2014-005626-35, 2014
Status last verified
Mar 2019
First submitted
30 Sep 2015
Last updated
25 Mar 2019
Results posted
No
Data monitoring committee
Yes

Questions about this trial

What is this clinical trial studying?

A Phase 1/2 study testing PRTX-100 in people with Immune Thrombocytopenia, run by Protalex, Inc. at 16 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 12 inclusion and 23 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: stopped early, as of the sponsor's last update on 25 Mar 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 16 sites in France, United Kingdom. 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 combined 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.

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?

The study was stopped early (reason given: Enough data has been collected to allow analysis of the safety profile and risk-benefit.). Results are not available in the source record.

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 treatment-related adverse events as assessed by Toxicity Grading Criteria based on RCTC v 2.0 and CTCAE v 4.03 (time frame: 337 Days). 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 25 Mar 2019.

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