A Study to Evaluate the Safety, Tolerability and Microbiome Dynamics of SER-287 in Subjects With Mild-to-Moderate Ulcerative Colitis

March 20, 2019 updated by: Seres Therapeutics, Inc.

A Phase 1B Multiple Dose Study to Evaluate the Safety, Tolerability and Microbiome Dynamics of SER-287 in Subjects With Mild-to-Moderate Ulcerative Colitis

A Multiple Dose Study to Evaluate the Safety, Tolerability and Microbiome Dynamics of SER-287 in Subjects with Mild-to-Moderate Ulcerative Colitis.

Study Overview

Detailed Description

This is a Phase 1b multicenter, randomized, double-blind, placebo-controlled multiple dose study designed to evaluate the safety and tolerability of SER-287, and to evaluate the microbiome alterations and pharmacodynamics associated with two dosing regimens of SER-287 in adult subjects with active mild-to-moderate ulcerative colitis (UC).

Study Type

Interventional

Enrollment (Actual)

58

Phase

  • Phase 1

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Massachusetts
      • Marlborough, Massachusetts, United States, 01752
        • Community Clinical Research Network

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 75 years (ADULT, OLDER_ADULT)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Ulcerative colitis diagnosed by routine clinical, radiographic, endoscopic and pathologic criteria (preferably confirmed by colonoscopy and pathology records within last 2 years or if unavailable, will need approval by medical monitor) Active mild-moderate UC as determined by sigmoidoscopy within approximately 3 days of randomization to study

Exclusion Criteria:

  1. Fever > 38.3°C
  2. Known or suspected toxic megacolon and/or known small bowel ileus
  3. Known history of Crohn's disease
  4. Subjects with serum albumin <2.5 g/dL at baseline
  5. CMV polymerase chain reaction (PCR) positive from blood plasma at screening
  6. Known stool studies positive for ova and/or parasites or stool culture within the 30 days before enrollment
  7. Subjects on cyclosporine or triple immunosuppression, Triple immunosuppression will include any three of the following classes of drugs taken in combination: steroids (i.e., prednisone/budesonide/budesonide MMX), immunosuppressant (i.e., methotrexate/azathioprine/6-mercaptopurine), and/or other immunosuppressant (i.e., tacrolimus, cellcept).
  8. Biologic medication (infliximab/ adalimumab/ golimumab/ certolizumab/vedolizumab/ustekinumab/natalizumab) use within 3 months prior to screening
  9. Known active malignancy except for basal cell skin cancer, squamous cell skin cancer
  10. Subjects with previous colectomy, ostomy, J-pouch, or previous intestinal surgery (excluding cholecystectomy, appendectomy)
  11. Subjects with known history of celiac disease or gluten enteropathy
  12. Subjects with Clostridium difficile positive stool at Screening Visit
  13. Antibiotic use within the prior 1 month before randomization
  14. Expected to receive antibiotics within 8 weeks of signing the Informed Consent Form (ICF) (i.e., for planned/anticipated procedure)
  15. Received an investigational drug within 1 month before study entry
  16. Received an investigational antibody or vaccine within 3 months before study entry
  17. Previously enrolled in a SER-109/SER-287 study
  18. Received an FMT within the last 6 months
  19. Subjects with anatomic or medical contraindications to flexible sigmoidoscopy, including but not necessarily limited to toxic megacolon, gastrointestinal (GI) fistulas, immediate post-operative status from abdominal surgery, severe coagulopathy, large or symptomatic abdominal aortic aneurysm, or any subject where study physician deems subject at significant risk of complications of flexible sigmoidoscopy
  20. Unable to stop steroid enemas or suppositories or mesalamine enemas or suppositories before screening visit
  21. Unable to stop opiate treatment unless on a stable dose and no increase in dose planned for the duration of the study
  22. Unable to stop probiotics before screening visit
  23. Concurrent intensive induction chemotherapy, radiotherapy, or biologic treatment for active malignancy (subjects on maintenance chemotherapy may only be enrolled after consultation with medical monitor)
  24. Known allergy or intolerance to oral vancomycin

    -

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: TREATMENT
  • Allocation: RANDOMIZED
  • Interventional Model: PARALLEL
  • Masking: DOUBLE

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
EXPERIMENTAL: Weekly SER-287, after Placebo Pre-Treat.
Placebo pre-treatment, followed by once weekly dosing of SER-287 for 8 weeks
Other Names:
  • Eubacterial Spores, Purified Suspension, Encapsulated
PLACEBO_COMPARATOR: Daily placebo, after Placebo Pre-Treat.
Placebo pre-treatment, followed by once daily placebo for 8 weeks
EXPERIMENTAL: Daily SER-287, after Vanco. Pre-Treat.
Vancomycin pre-treatment, followed by once daily dosing of SER-287 for 8 weeks
Other Names:
  • Eubacterial Spores, Purified Suspension, Encapsulated
EXPERIMENTAL: Weekly SER-287, after Vanco. Pre-Treat.
Vancomycin pre-treatment, followed by once weekly dosing of SER-287 for 8 weeks
Other Names:
  • Eubacterial Spores, Purified Suspension, Encapsulated

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Safety and Tolerability of SER-287
Time Frame: Day 246
Treatment-Emergent Adverse Events Incidence by Treatment, System Organ Class and Preferred Term. The treatment period with SER-287 was eight weeks. All AEs were collected from the date of Informed Consent (up to 17 days of Screening) through Day 92 of the study. All SAEs were collected from the date of Informed Consent through Day 246 of the study.
Day 246
Composition of the Intestinal Microbiome
Time Frame: Baseline and 8 weeks
Changes in the composition of the microbiome were characterized by whole metagenomic sequencing (WMS) of subjects' stool samples. Changes in the composition of the microbiome were measured by quantifying the number of unique types of spore-forming bacteria detected in subjects' stool samples after eight weeks of induction treatment versus baseline.
Baseline and 8 weeks
Engraftment of SER-287 Bacteria in All Treatment Arms
Time Frame: Baseline and 8 weeks
The stool microbiomes of SERES-101 subjects, before and after treatment with SER-287, were characterized using whole metagenomic sequencing (WMS). SER-287 drug product was also characterized using WMS. Microbiome engraftment was assessed by the number of spore-forming species in the drug product lots that were also detected in subjects' post-treatment fecal samples but not detected at baseline.
Baseline and 8 weeks

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Clinical Remission
Time Frame: 8 weeks

Defined as a Total Modified Mayo Score <= 2 and an endoscopic subscore <= 1.

The Total Modified Mayo Score is a measure of UC disease activity which ranges from 0 to 12 points and consists of four subscores (stool frequency, rectal bleeding, endoscopy, and physician global assessment), each graded from 0 to 3, with higher scores indicating more severe disease. The four components are summed together for a composite score, with a higher overall score indicating more severe disease (0 = no disease; 12 = worst disease). The Modified Mayo endoscopic subscore excludes friability from an endoscopic subscore of 1.

8 weeks
Endoscopic Improvement
Time Frame: 8 weeks
Defined as a decrease in endoscopic subscore >= 1
8 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (ACTUAL)

January 13, 2016

Primary Completion (ACTUAL)

December 6, 2017

Study Completion (ACTUAL)

January 26, 2018

Study Registration Dates

First Submitted

November 20, 2015

First Submitted That Met QC Criteria

November 25, 2015

First Posted (ESTIMATE)

December 1, 2015

Study Record Updates

Last Update Posted (ACTUAL)

June 20, 2019

Last Update Submitted That Met QC Criteria

March 20, 2019

Last Verified

March 1, 2019

More Information

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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