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AVONEX to Treat Severe Ulcerative Colitis
This study is currently recruiting participants.
Verified by National Institutes of Health Clinical Center (CC), August 2008
Sponsored by: National Institute of Allergy and Infectious Diseases (NIAID)
Information provided by: National Institutes of Health Clinical Center (CC)
ClinicalTrials.gov Identifier: NCT00750490
  Purpose

This study will evaluate the effectiveness of Avonex (interferon-beta-1a), a drug approved to treat multiple sclerosis, in controlling the symptoms of ulcerative colitis. People with ulcerative colitis have increased levels of an inflammatory chemical made by the body called IL-13. Avonex may inhibit production of IL-13 and interrupt the inflammatory process in the colon.

People between 18 and 65 years of age who have had ulcerative colitis for at least 6 months may be eligible for this study as follows:

Screening Visits

  • Medical history, review of medical records, physical examination, electrocardiogram (EKG)
  • Collection of blood, urine and stool samples
  • Completion of questionnaires and symptoms ratings, start 7-day symptoms diary
  • Colonoscopy to determine amount of inflammation and obtain tissue samples
  • Random assignment to take Avonex or placebo during the study

    0-week Visit (3 to 7 days after colonoscopy)

  • Physical examination
  • Questionnaires, rating scales and review of ulcerative colitis symptoms
  • Blood sample
  • First injection of Avonex or placebo and instruction on how to self-inject the treatment

    4-week, 8-week and 12-week Visits

  • Repeat of 0-week procedures
  • Urine sample
  • Colonoscopy
  • Review of study treatment dosing diary

    16-week Visit

  • Repeat of 0-week procedures
  • Urine sample
  • EKG

Subjects may be asked to participate in a substudy, in which they undergo all the above procedures as well as the following:

  • Extra blood draw at screening and 8-week visit to collect a specific type of blood cell for study
  • Up to 30 biopsies of gut mucosa during the screening and 8-week colonoscopies

Condition Intervention Phase
Inflammatory Bowel Disease
Colitis
Digestive Disease
Ulcerative Colitis
Drug: AVONEX
Phase II

Genetics Home Reference related topics: Crohn disease
MedlinePlus related topics: Digestive Diseases Ulcerative Colitis
Drug Information available for: Interferons Interferon beta Interferon-beta Interferon beta 1a
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Randomized, Double-Blind, Placebo Control, Single Group Assignment, Safety/Efficacy Study
Official Title: A Multicenter, Randomized Double-Blind, Placebo-Controlled Study to Evaluate the Safety and Tolerability, and Efficacy of AVONEX in Subjects With Moderate to Severe Ulcerative Colitis

Further study details as provided by National Institutes of Health Clinical Center (CC):

Primary Outcome Measures:
  • Clinical response at week 8 as defined as a decrease from baseline in the total Mayo Score/Disease Activity Index (DAI) of at least 3 points and at least 30 %, accompanied by a decrease in the subscore for rectal bleeding of at least 1 point. [ Time Frame: 8 weeks ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Safety and tolerability of AVONEX and the percentage of subjects with a decrease in SCCAI Score of greater than or equal to 3 points at week 8. [ Time Frame: 8 weeks ] [ Designated as safety issue: No ]

Estimated Enrollment: 20
Study Start Date: September 2008
Intervention Details:
    Drug: AVONEX
    N/A
Detailed Description:

The objective of this National Institutes of Health (NIH) specific substudy is immunological monitoring of cytokine and immune cell responses in subjects undergoing treatment with AVONEX (Interferon-beta 1a) for moderate to severe ulcerative colitis. Recent data suggests that interleukin-14 (IL-13) is an important mediator of inflammation in ulcerative colitis, and type-I interferons such as AVONEX have the potential to block IL-13 signaling. In addition, 4 small clinical studies have showed that type I interferons have therapeutic activity in ulcerative colitis. This study will measure changes in cytokine production, relevant RNA expression, and immune cell populations (in the periphery and lamina propria) for correlation with clinical outcomes in order to understand the mechanisms of therapeutic response.

  Eligibility

Ages Eligible for Study:   18 Years to 65 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria
  • INCLUSION CRITERIA:

    1. Must give written informed consent and any authorizations required by local law
    2. Aged 18 to 65 years old, inclusive, at the time of informed consent.
    3. Must have an established diagnosis of UC for greater than or equal to 6 months
    4. Must have endoscopy (flexible sigmoidoscopy or colonoscopy if clinically indicated) with biopsy to confirm the diagnosis of UC
    5. Must have greater than 20 cm of active disease at Screening endoscopy.
    6. Must have active UC with Mayo Score/DAI of 6 to 13 points and moderate to severe disease on endoscopy (Mayo endoscopic score of at least 2) despite prior or concomitant treatment with corticosteroids, azathioprine, 6-mercaptopurine, or any combination thereof.
    7. Colonoscopy within the past 5 years for extent of disease and to exclude polyps.
    8. For subjects with UC for greater than 10 years, colonoscopy with appropriate biopsies within 1 year prior to Screening to exclude dysplasia and neoplasia.
    9. If receiving corticosteroid treatment prior to Screening, subjects must be willing to maintain stable doses until Week 8.
    10. Prior to screening, subjects must be taking stable doses of 6-mercaptopurine or azathioprine for 12 weeks, and be willing to maintain stable doses until Week 12.
    11. If subjects are taking 5-aminosalicylic acid prior to screening, they must be willing to maintain stable doses until Week 12.
    12. Subjects must be willing and able to comply with a 7-day UC symptom collection by IVRS telephone diary as assessed during the Screening period.
    13. All male subjects and female subjects of child-bearing potential must be willing and able to practice effective birth control during the study and be willing and able to continue contraception for 1 month after their last dose of study treatment.

EXCLUSION CRITERIA:

  1. Subjects with a diagnosis of indeterminate colitis or Crohn's disease.
  2. Subjects with clinical findings suggestive of Crohn's disease, eg., fistulae or granulomas on biopsy.
  3. Subjects with an imminent need for surgery.
  4. Subjects with toxic megacolon.
  5. Subjects with primary sclerosing cholangitis.
  6. Any of the following abnormal laboratory results:

    • ALT and AST greater than or equal to 2 times ULN
    • Hemoglobin less than or equal to 9 g/dL
    • WBC less than 3500 cells/mm(3)
    • Lymphocyte count less than 1000 cells/microL
    • Platelet count less than 100,00 cells/microL
  7. Female subjects who are pregnant or who wish to become pregnant during the study, or who are lactating.
  8. Subjects with know symptomatic colonic stricture.
  9. Stool culture positive for enteric infection, including parasitic and C. difficile infection.
  10. Subjects who are positive for HBsAg, HCV, or HIV at Screening

    (Medical History)

  11. Subjects with a history of malignant disease, including solid tumors and hematologic malignancies (except basal cell and squamous cell carcinomas of the skin that have been completely excised and are considered cured).
  12. Subjects with a history of depression and/or suicidal ideation.
  13. History of severe allergic or anaphylactic reactions.
  14. History of intolerance to acetaminophen (paracetamol) that would preclude its use during the study period.
  15. Subjects with a history of colonic or small bowel obstruction or resection.
  16. Subjects with a history of colonic or small bowel obstruction or resection.
  17. History of any clinically significant cardiac disease (including cardiomyopathy, congestive heart failure or related risk factors), or endocrinologic, hematologic, hepatic, immunologic, metabolic, urologic, pulmonary, neurologic (including untreated or unstable seizures), dermatologic, renal, and psychiatric or other major disease, as determined by the Investigator. This includes psychosis, schizophrenia, mania, or major psychiatric illness requiring pharmacological treatment. Patients with a clinical diagnosis of anorexia nervosa or bulimia nervosa are excluded from the study.
  18. Known active bacterial, viral, fungal, mycobacterial, or other infection (including tuberculosis or atypical mycobacterial disease, but excluding fungal infections of nail beds) or any major episode of infection requiring hospitalization or treatment with IV antibiotics within 4 weeks of Screening.
  19. Serious local infection (e.g., cellulitis, abscess) or systemic infection (e.g., pneumonia, septicemia) within 6 months prior to Screening.
  20. History of drug or alcohol abuse (as defined by the Investigator) within the 2 years prior to Screening.

    (Treatment History)

  21. Treatment with another study treatment or approved therapy for investigational uses within the 4 weeks prior to the first dose of study treatment.
  22. Exposure to monoclonal antibodies, cytokines, growth factors, soluble receptors, other recombinant products, or fusion proteins within 8 weeks prior to Screening.
  23. Treatment with anti-TNF agents within 12 weeks prior to Screening.
  24. Treatment with methotrexate, cyclosporine, tacrolimus, sirolimus, or mycophenolate mofetil within 8 weeks prior to Screening.
  25. Regular use of nonsteroidal anti-inflammatory drugs (NSAIDs) other than low dose aspirin within 4 weeks prior to Screening.
  26. Use of oral antibiotics for any reason within 2 weeks prior to Screening.
  27. Treatment with rectally administered corticosteroids or rectally administered medications containing 5-aminosalicylates within 2 weeks prior to Screening.
  28. Use of antidiarrheal agents during the screening period (between Screening and Visit 1)
  29. Previous participation in this study.
  30. Previous treatment with interferon Beta or other interferon products.

    (Miscellaneous)

  31. Blood donation (1 unit or more) within 2 months prior to Screening.
  32. Current enrollment in any other study treatment or disease study.
  33. Inability to comply with study requirements.
  34. Other unspecified reasons that, in the opinion of the Investigator or Biogen Idec, make the subject unsuitable for enrollment.

SUB STUDY

INCLUSION CRITERIA

You must be enrolled in the main protocol to participate in the substudy.

EXCLUSION CRITERIA

Platelet count less than 90,000 per milliliter

Prothrombin time International Normalized Ratio greater than 1.3 or partial thromboplastin time greater than 3 seconds control.

  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00750490

Contacts
Contact: Patient Recruitment and Public Liaison Office (800) 411-1222 prpl@mail.cc.nih.gov
Contact: TTY 1-866-411-1010

Locations
United States, Maryland
National Institutes of Health Clinical Center, 9000 Rockville Pike Recruiting
Bethesda, Maryland, United States, 20892
Sponsors and Collaborators
  More Information

NIH Clinical Center Detailed Web Page  This link exits the ClinicalTrials.gov site

Publications:
Responsible Party: ( Alisa Dungy )
Study ID Numbers: 080209, 08-I-0209
Study First Received: September 9, 2008
Last Updated: November 11, 2008
ClinicalTrials.gov Identifier: NCT00750490  
Health Authority: United States: Federal Government

Keywords provided by National Institutes of Health Clinical Center (CC):
Interferon Beta 1-a
IM Injection
IL-13
Inflammation
Neopterin
Ulcerative Colitis
Inflammatory Bowel Disease
Colitis

Study placed in the following topic categories:
Gastrointestinal Diseases
Ulcer
Colonic Diseases
Interferons
Interferon-beta
Inflammatory Bowel Diseases
Colitis, Ulcerative
Intestinal Diseases
Inflammation
Digestive System Diseases
Interferon beta 1a
Gastroenteritis
Colitis

Additional relevant MeSH terms:
Pathologic Processes
Immunologic Factors
Antineoplastic Agents
Therapeutic Uses
Physiological Effects of Drugs
Adjuvants, Immunologic
Pharmacologic Actions

ClinicalTrials.gov processed this record on January 16, 2009