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The Use of Anti-CD4 Monoclonal Antibody (mAb)-Fragment for the Imaging of Chronic Inflammation in Patients With Active Rheumatoid Arthritis

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00372177
Recruitment Status : Completed
First Posted : September 6, 2006
Last Update Posted : May 28, 2008
Technische Universität Dresden
University of Leipzig
Information provided by:
Biotectid GmbH

Brief Summary:

Rheumatoid arthritis (RA) is a disease with a large economic impact due to the long lasting disabling nature of the disease. Furthermore, diagnosis of the disease is difficult and only a scheme with different symptoms is used to diagnose rheumatoid arthritis, often only by probability.

Due to the fact that effective disease modifying pharmacological treatment is available and should be started early in established cases of RA, in combination with the adverse effect potential of these substances (e.g. methotrexate), a fast reliable diagnostic tool to diagnose rheumatoid arthritis would be highly appreciated by the medical community and the patients. Furthermore, for invasive treatments (surgery, puncture), an imaging method to display the activity pattern in different joints would be a major advantage.

For the evaluation of the effectiveness of pharmacological therapy in rheumatoid arthritis, up to now, radiological measurements of the destruction process of the joints are used. This method has the disadvantage that it is time consuming insofar as changes in the radiological images must occur. It allows only an evaluation if the joints are destructed (which should be excluded by the new therapy regimen). Again, a quantifiable method for the determination of the effects of new therapeutic approaches would be highly appreciated.

Condition or disease Intervention/treatment Phase
Rheumatoid Arthritis Polyarthritis Rheumatism Autoimmune Disease Inflammation Radiation: Fab-fragment of Anti-human CD4 Phase 1 Phase 2

Detailed Description:

The substance will be used as iv injection due to the protein nature of the antibody and, to ensure a fast distribution within the body. The study will be performed as an open clinical trial due to the fact that the applied radiation has to be documented; the use of "placebo" radiation would be unethical.

It is expected, that the new antibody fragment with its radioactive linkage will display an image of the activity distribution of the disease. Due to the fact that only patients with active disease have to be imaged and, to allow for comparison of the activity and the clinical distribution of the disease, this proof of concept study (phase I study) will be performed in patients with active disease. Healthy volunteers could not display an activity pattern of the disease. Furthermore, it seems to be unethical to use volunteers for studies with radioactivity with such a risk/benefit ratio (radiation risks vs. missing chance of display of tissue distribution) in a proof of concept study.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 5 participants
Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Diagnostic
Official Title: The Use of Anti-CD4 mAb-Fragment for the Imaging of Chronic Inflammation in Patients With Active Rheumatoid Arthritis (an Open Proof of Concept Study)
Study Start Date : July 2007
Actual Primary Completion Date : May 2008
Actual Study Completion Date : May 2008

Resource links provided by the National Library of Medicine

Arm Intervention/treatment
Active Comparator: EP1645
Radiation: Fab-fragment of Anti-human CD4
Sterile lyophilized Powder for Preparation of a Solution and sterile labelling Buffer labelling with Tc99m-Pertechnetat Intravenous injection

Primary Outcome Measures :
  1. safety and tolerability of this diagnostic agent [ Time Frame: duration of study ]

Secondary Outcome Measures :
  1. endpoint for the proof of concept will be the number of patients needed to obtain a series of equal results [ Time Frame: duration of study ]

Information from the National Library of Medicine

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Ages Eligible for Study:   50 Years to 80 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Male and female subjects above 50 years of age
  • Suffering from joint pain which is due to active rheumatoid arthritis
  • Obvious signs of inflammation in at least one joint (e.g. swelling, erythema, or local elevated temperature)
  • Otherwise healthy
  • Informed consent

Exclusion Criteria:

  • Patients 80 years and older
  • Clinically significant disease of the cardiovascular system, respiratory system, hepato-biliary system or central nervous system (CNS)
  • Excretory hepatic or renal insufficiency
  • Regular intake of any drug, except for hormone replacement therapy in females
  • Previous administration of xenogenous proteins
  • History of anaphylactic reaction to any drug administered by a parenteral pathway
  • Previous participation in a radiopharmaceutical drug trial (unless the effective dose acquired by participation in the current trial will remain below 10 mSv)
  • Participation in any clinical drug trial within 3 months prior to enrolment
  • Women of child-bearing potential (child-bearing potential to be ruled out by one of the following: at least 2 years past menopause, hysterectomy, bilateral oophorectomy, or bilateral tubal ligation)
  • Long term medication with strong antiphlogistic agents/pain killers such as methotrexate, corticoids, or immunosuppressants prior to enrolment

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00372177

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Clinic and Policlinic for Nuclear Medicine, Medical faculty, University of Leipzig
Leipzig, Saxony, Germany, 04103
Sponsors and Collaborators
Biotectid GmbH
Technische Universität Dresden
University of Leipzig
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Principal Investigator: Osama Sabri, Prof. Dr. Clinic and Policlinic for Nuclear Medicine, Medical Faculty, University of Leipzig, Germany
Additional Information:
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Responsible Party: Biotectid GmbH Identifier: NCT00372177    
Other Study ID Numbers: Biotectid POC EP 1645
EP 1645
First Posted: September 6, 2006    Key Record Dates
Last Update Posted: May 28, 2008
Last Verified: May 2008
Keywords provided by Biotectid GmbH:
monoclonal antibody
molecular target
Fab-fragment of Anti-human CD4
chronic inflammatory diseases
active Rheumatoid Arthritis
Additional relevant MeSH terms:
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Arthritis, Rheumatoid
Rheumatic Diseases
Autoimmune Diseases
Joint Diseases
Musculoskeletal Diseases
Pathologic Processes
Connective Tissue Diseases
Immune System Diseases
Immunoglobulin Fab Fragments
Immunologic Factors
Physiological Effects of Drugs