LOW DOSE IL-2 FOR THE TREATMENT OF CROHN'S DISEASE
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|ClinicalTrials.gov Identifier: NCT04263831|
Recruitment Status : Not yet recruiting
First Posted : February 11, 2020
Last Update Posted : February 11, 2020
|Condition or disease||Intervention/treatment||Phase|
|Crohn Disease||Drug: Interleukin-2 (aldesleukin).||Phase 1 Phase 2|
Despite recent advances in treatment, a significant proportion of patients with Crohn's disease have suboptimal responses to medical therapy, leaving an urgent need to identify new therapies. One promising new approach to trea t IBD is through the manipulation of regulatory T cells (Tregs). Tregs are an immune modulating subset of CD4+ lymphocytes that antagonize the activation and effector function of multiple immune cell types and promote tolerance to self-antigens. Adoptively transferred Tregs are effective in murine models of IBD. An alternative approach to disease management through Treg manipulation is to increase Treg numbers in vivo. Interleukin-2 (IL-2, Proleukin®) is a T cell growth factor. IL-2 is currently licensed for the treatment of metastatic renal cell carcinoma and metastatic melanoma. At low doses, IL-2 promotes the selective activation and expansion of Tregs in humans. Tregs constitutively express CD25, a component of the high-affinity IL-2R, while CD25 is only transiently expressed by activated conventional T effector cells. Low-dose (LD) IL-2 selectively expands Tregs in humans and is safe in chronic GvHD and other phase 1 and 2 clinical trials.
This is a phase 1b/2a clinical trial to assess the safety and the efficacy of LD SC IL-2 for the treatment of CD utlizing daily sc LD IL-2 for 8 weeks in CD patients to determine the maximum effective dose (MED) and safety profile, and to assess a signal of efficacy. We aim to determine in CD patients whether sc LD IL-2 modulates peripheral blood and lamina propria Tregs in vivo and correlates with clinical outcome. We will perform deep immunophenotyping in CD patients treated with LD IL-2 and comprehensively assess the effects of LD IL-2 on CD4+ Tregs and other immune cells in both peripheral and mucosal compartments, and correlate changes in immune phenotype with clinical outcome. Overall this trial is designed to determine the MED and safety profile of LD IL-2 in CD, to obtain a signal of efficacy, and to assess mechanistic underpinnings.
|Study Type :||Interventional (Clinical Trial)|
|Estimated Enrollment :||30 participants|
|Intervention Model:||Single Group Assignment|
|Masking:||None (Open Label)|
|Official Title:||LOW DOSE IL-2 FOR THE TREATMENT OF CROHN'S DISEASE|
|Estimated Study Start Date :||July 1, 2020|
|Estimated Primary Completion Date :||December 31, 2023|
|Estimated Study Completion Date :||December 31, 2024|
Study drug: Interleukin-2 (aldesleukin, Proleukin, IL-2).
Each subject will receive an 8-week course of once-daily, subcutaneously administered IL-2. There will be two dose cohorts. Each subject will be recruited into a single dose cohort and receive a single dose level of IL-2 throughout the study.
The dose levels will be as follows:
Cohort 1: 1.0x10^6 IU/m^2/day. Cohort 2: 1.25x10^6 IU/m^2/day.
Drug: Interleukin-2 (aldesleukin).
Description of intervention is covered in "Arm", above.
- Number of subjects with serious and non-serious adverse events. [ Time Frame: 8 weeks ]Enumeration of the serious and non-serious adverse events seen in the study. Enumeration of any dose limiting toxicity seen in the study.
- Maximum effective dose [ Time Frame: 8 weeks ]Identification of the dose cohort at which the MED occurs.
- Clinical Response [ Time Frame: 8 weeks ]
This is a composite endpoint. CDAI scores will be used to assess clinical activity. Moderate to severe CD, denoted by a CDAI score 220-450, is an inclusion criterion.
Definition of Clinical Response. CDAI-100 response (≥100-point decrease in the CDAI score) at week 8 Composite Outcome: Clinical response and atleast a 50% decrease in fecal calprotectin or CRP
- Immunological Response [ Time Frame: 12 weeks ]Enumeration of the number of subjects with a change in the absolute number of immune cells in the peripheral blood and lamina propria of subjects during the 8 weeks of treatment, and during the 4 weeks following cessation of treatment.
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 ClinicalTrials.gov identifier (NCT number): NCT04263831
|Contact: Jonathan Hurtadofirstname.lastname@example.org|
|Contact: Sydney Whitcomb||Sydney.Whitcomb@childrens.harvard.edu|
|United States, Massachusetts|
|Boston Children's Hospital|
|Boston, Massachusetts, United States, 02115|
|Contact: Sydney Whitcomb Sydney.Whitcomb@childrens.harvard.edu|
|Brigham and Women's Hospital|
|Boston, Massachusetts, United States, 02115|
|Contact: Jonathan Hurtado 617-525-7322 email@example.com|
|Principal Investigator:||Scott Snapper, MD, PhD||Boston Children’s Hospital|
|Principal Investigator:||Jessica Allegretti, MD, MPH||Brigham and Women's Hosptial|