Part A Primary Objective To determine the safety of six months of PRTX-100 administration. Part B Primary Objective To obtain antisera from normal volunteers that have developed anti-PRTX-100 antibodies. Secondary Objective(s) To assess rheumatoid arthritis activity during the period of PRTX-100 treatment To evaluate the development of anti-PRTX-100 antibodies To explore feasibility of joint evaluations with ultrasound To explore feasibility of biomarkers as disease markers
Although the majority of RA patients achieve an amelioration of their RA with older disease modifying agents such as methotrexate and leflunomide, all of these agents provoke adverse events. The newer more active biological agents have a distinct safety profile that includes an increased risk of serious infections. They have an annual treatment expense in the tens of thousands of dollars a year. PRTX-100 may be able to modify the disease course of rheumatoid arthritis with an improved safety profile compared to available agents and a dosing regimen comparable to the therapies currently available. This study is done to describe the adverse event profile of 6 μg/kg of PRTX-100 administered IV for longer periods of treatment that might be required for RA therapy. Secondary objectives include: evaluation of the clinical response of subjects with previous administration of PRTX-100; evaluation of anti-PRTX antibody presence and effect on activity; evaluation of "Power Doppler" ultrasound in the assessment of joint inflammation; and evaluation of biomarkers. Assay development is an intrinsic part of drug and biological development. The current assay for anti-PRTX-100 antibodies depends on a very limited supply of serum available from individuals in early trials. It will be necessary to obtain adequate antisera to provide immunological reagents for this assay. It is not known whether the character of anti-PRTX-100 antibodies from volunteers is similar to those produced by patients with immunological disorders on cytotoxic therapy. Antisera will be developed in normal volunteers. The anti-PRTX-100 antibody assay will need to be standardized with a new anti-PRTX-100 antibody source compared to the present human reagent.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
6 micrograms PRTX-100 per kilogram of body weight administered via infusion
Protalex Investigational Site
Coeur d'Alene, Idaho, United States
Safety (Analysis of Adverse Events)
Number, severity, and attribution of relatedness of Adverse Events will be analyzed.
Time frame: 6 months
ACR-28 joint count
ACR 28-joint counts (number of tender and swollen joints) will be summarized descriptively by assessment time point in addition to change and percent change from baseline values, as well as in categorical analyses for disease activity.
Time frame: 6 months
Patient's global assessment of disease activity
Patient's global assessment of disease activity (0-10) will be summarized descriptively by assessment time point in addition to change and percent change from baseline values, as well as in categorical analyses for disease activity.
Time frame: 6 months
Patient's assessment of pain VAS
Patient's assessment of pain VAS (0-10) will be summarized descriptively by assessment time point in addition to change and percent change from baseline values, as well as in categorical analyses for disease activity.
Time frame: 6 months
Physician's global assessment of disease activity
Physician's global assessment of disease activity (0-10) will be summarized descriptively by assessment time point in addition to change and percent change from baseline values, as well as in categorical analyses for disease activity.
Time frame: 6 months
MDHAQ - Physical Function
MDHAQ Physical Function (0-10) will be summarized descriptively by assessment time point in addition to change and percent change from baseline values, as well as in categorical analyses for disease activity.
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Masking
NONE
Enrollment
13
Time frame: 6 months
MDHAQ - Joint Pain
MDHAQ Joint Pain (0-48) will be summarized descriptively by assessment time point in addition to change and percent change from baseline values, as well as in categorical analyses for disease activity.
Time frame: 6 months
MDHAQ - Fatigue
MDHAQ Fatigue (0-10) will be summarized descriptively by assessment time point in addition to change and percent change from baseline values, as well as in categorical analyses for disease activity.
Time frame: 6 months
RAPID 3
RAPID 3 (0-30) will be summarized descriptively by assessment time point in addition to change and percent change from baseline values, as well as in categorical analyses for disease activity.
Time frame: 6 months
CDAI
Clinical Disease Activity Index (0-76) will be summarized descriptively by assessment time point in addition to change and percent change from baseline values, as well as in categorical analyses for disease activity.
Time frame: 6 months
DAS28-CRP
DAS28-CRP (0-10) will be summarized descriptively by assessment time point in addition to change and percent change from baseline values, as well as in categorical analyses for disease activity.
Time frame: 6 months
hsCRP
C-Reactive Protein (hsCRP) lab values (mg/dL) will be summarized descriptively by assessment time point in addition to change and percent change from baseline values, as well as in categorical analyses for disease activity.
Time frame: 6 months
ESR
Erythrocyte Sedimentation Rate (mm/hr) will be summarized descriptively by assessment time point in addition to change and percent change from baseline values, as well as in categorical analyses for disease activity.
Time frame: 6 months
Biomarker Correlation
Vectra-DA scores (1-100) will be summarized descriptively by assessment time point in addition to change and percent change from baseline values, as well as in categorical analyses for disease activity.
Time frame: 6 months
Disease activity
ACR 28-joint counts (tender and swollen), patient's global assessment of disease activity, patient's assessment of pain VAS, physician's global assessment of disease activity, MDHAQ (overall, physical function, joint pain, and fatigue), RAPID 3, CDAI, DAS28-CRP, CRP, ESR, Vectra-DA, and UPD joint counts, will be summarized descriptively by assessment time point in addition to change and percent change from baseline values, as well as in categorical analyses for disease activity.
Time frame: 6 months
Ultrasound Power Doppler Joint Count
UPD joint counts (0-36) will be summarized descriptively by assessment time point in addition to change and percent change from baseline values, as well as in categorical analyses for disease activity.
Time frame: 6 months
Immunogenicity
The occurrence of anti-PRTX-100 antibodies (positive/negative) will be summarized descriptively for the observed values and change from baseline results.
Time frame: 6 months