Open Label, Multicentre Trial to Assess Safety and Efficacy of ITF2357 in Active Systemic Juvenile Idiopathic Arthritis

NCT ID: NCT00570661

Last Updated: 2021-05-04

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE2
• Total Enrollment: 17 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2006-09-12
• Study Completion Date: 2013-06-10

Brief Summary

This study has the following objectives:

Primary objective:

• To determine the safety and tolerability of oral ITF2357 in patients with active SOJIA with inadequate response or intolerance to standard therapy with oral steroids and methotrexate, with or without previously used biologic agents.

Secondary objectives:

• to evaluate the effect of ITF2357 on disease activity in patients with active SOJIA
• to investigate the possibility of steroid dose tapering in patients with active SOJIA during ITF2357 treatment
• to assess the effect of ITF2357 on levels of circulating cytokines
• to assess the pharmacokinetic properties of ITF2357

Detailed Description

The present study has been designed in order to evaluate safety and tolerability of ITF2357 in patients with active SOJIA with inadequate response or intolerance to standard therapy with oral steroids and methotrexate, with or without previously used biologic agents, and to have a preliminary evaluation of efficacy of ITF2357 in the treatment of SOJIA.

ITF2357 will be administered orally at the daily cumulative dose of 1.5 mg/kg: this dose in children/young adults is considered roughly equivalent to the dose of 1 mg/kg/day in adults, which so far has been proven to be free of any relevant safety concerns both in healthy volunteers and in patients.

Conditions

Active Systemic; Onset Juvenile Idiopathic Arthritis

Study Design

• Allocation Method: NA
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

ITF2357

ITF2357 hard gelatine capsules were administered orally, in fed conditions, at the cumulative daily dose of 1.5 mg/kg achieved by administration of 0.75 mg/kg at 12-hour interval for 4 weeks initially. The doses of 1.5 mg/kg/day were achieved by administration of an appropriate number of capsules of definite strength (dose strengths of 7.5, 10, 12.5, 15, 20 mg and 50 mg).

Treatment was further prolonged up to 12 weeks in total if so suggested by the observed benefits and the lack of treatment-limiting toxicity

Group Type: EXPERIMENTAL

ITF2357

Intervention Type: DRUG

ITF2357 orally administered at the cumulative daily dose of 1.5 mg/kg, achieved by administration of different dose strengths identifiable by different colours.

Interventions

ITF2357

ITF2357 orally administered at the cumulative daily dose of 1.5 mg/kg, achieved by administration of different dose strengths identifiable by different colours.

Intervention Type: DRUG

Other Intervention Names

Givinostat, histone deacetylase inhibitor

Eligibility Criteria

Inclusion Criteria

1. Established diagnosis of Systemic SOJIA according to ILAR criteria for at least six months before the study entry, with inadequate response or intolerance to standard therapy with oral steroids and/or methotrexate, with or without previously used biologic agents.

2. Active disease for at least one month prior to enrolment as defined by the following criteria:

• Presence of arthritis plus at least one of the following:

• Fever, defined as a body temperature >= 37,5 C degree at least once a day during at least five consecutive days or presence of typical SOJIA intermittent temperature chart
• Rash, defined by presence of typical SOJIA salmon pink rash on the trunk and elsewhere during the febrile episodes
• Serositis (pericarditis, pleuritis, peritonitis) confirmed by ultrasound and/or X-ray exploration or by presence of typical ECG findings in the case of pericarditis
• Lymphadenopathy, defined by lymph nodes enlargement to 1,5 cm or more localized anywhere within the body, and/or hepatomegaly and/or splenomegaly, confirmed by ultrasound evaluation and established after comparison to age standards for organ size
• ESR >= 20 mm/h (first hour) and/or CRP >= 10 mg/L. in the absence of arthritis, two definite or one definite and one probable diagnostic criteria plus ESR >=20 mm/h (first hour) and/or CRP >=10 mg/L

3. Age at enrolment between 2 and 25 years

4. Age at first SOJIA diagnosis < 16 years

5. Previously introduced standard treatment of disease with steroids without satisfactory effect and concomitant treatment with oral steroids at a dose equivalent to >= 0,2 mg/kg/day of prednisolone, unmodified for at least four weeks before patient's enrolment

6. In case of concomitant methotrexate treatment, it has to be on stable dose >= 10mg/m2 weekly for al least 4 weeks before pt enrollment

7. Previous treatment with biologics, if any, during at least three months without satisfactory effect or with drug intolerability, discontinued for at least the period specified below before patient's enrolment:

• Two months for etanercept
• Six months for infliximab

8. Other disease-modifying anti-rheumatic drugs possibly previously introduced have to be discontinued for a period of at least five half lives

9. Concomitant nonsteroidal anti-inflammatory drugs, if any, on a stable dose for at least four weeks before patient's enrolment

10. Female of childbearing potential, using safe contraceptive measures

11. Signed written informed consent before starting any study procedure

Exclusion Criteria

1. Ongoing clinical relevant viral infection (eg.: Herpes Zoster, Ebstein barr, CMV, Systemic fungal infections or history of recurrent serious bacterial infection)

2. History of macrophage activation syndrome

3. Clinically significant illness i.e. any condition (including laboratory abnormalities) that in the opinion of the Investigator places the patient to unacceptable risk for adverse outcome if he/she were to participate in the study

4. Psychiatric illness/social situations that would limit compliance with study medication and protocol requirements

5. Congenital heart and/or central nervous system disorders

6. Inherited metabolic diseases

7. Positive serological testing for anti HCV, anti HIV and HBsAg (to be performed at screening)

8. Pregnant or lactating women

9. Presence of malignancy

10. Any previous evidence, irrespective of its severity, of coronary disease, cardiac rhythm abnormalities or congestive heart failure

11. QTc interval > 450 msec at screening evaluation

12. Serum magnesium and potassium below the LLN at screening

13. Unavoidable concomitant treatment with any drug known for potential risk of causing Torsades de Pointes

• Minimum Eligible Age: 2 Years
• Maximum Eligible Age: 25 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Italfarmaco

INDUSTRY

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Nemanja Damjanov, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Institute of Rheumatology Belgrade

Locations

Clinica Institute Fundeni.Pediatric Clinic 258 Sos. Fundeni,

Bucharest, , Romania

Clinical Emergency Children Hospital "M.S. Curie" Paediatric Clinic no. I 20 Ctin. Brancoveanu Bvd., 041451 Bucharest 4th district

Bucharest, , Romania

University Clinical Centre NisClinic of Paediatrics Department for Rheumatology Bul Dr Zoran Djindjica

Niš, Nis, Serbia

Mother and Child Health Institute "Dr. Vukan Cupic" Clinic of Paediatrics Radoja Dakica

Belgrade, Novi Belgrade, Serbia

Institute of Rheumatology Belgrade Resavska

Belgrade, , Serbia

Countries

Romania; Serbia

References

Vojinovic J, Damjanov N, D'Urzo C, Furlan A, Susic G, Pasic S, Iagaru N, Stefan M, Dinarello CA. Safety and efficacy of an oral histone deacetylase inhibitor in systemic-onset juvenile idiopathic arthritis. Arthritis Rheum. 2011 May;63(5):1452-8. doi: 10.1002/art.30238.

Reference Type: DERIVED

PMID: 21538322 (View on PubMed)

Vojinovic J, Damjanov N. HDAC inhibition in rheumatoid arthritis and juvenile idiopathic arthritis. Mol Med. 2011 May-Jun;17(5-6):397-403. doi: 10.2119/molmed.2011.00030. Epub 2011 Feb 4.

Reference Type: DERIVED

PMID: 21308151 (View on PubMed)

Other Identifiers

DSC/05/2357/19

Identifier Type: -

Identifier Source: org_study_id