TRL1068 is expected to eliminate the pathogen-protecting biofilm in the prosthetic joint and surrounding tissue, thus making these pathogens substantially more susceptible to established antibiotic treatment regimens. This initial study is designed to assess overall safety and pharmacokinetics (PK) of TRL1068. The overall goal of the development program is to demonstrate that TRL1068 can facilitate effectiveness of a single stage joint replacement or preservation of the original infected prosthetic joint in a substantial proportion of patients with PJI.
Approximately 75% of all clinically significant human infections are estimated to be biofilm-related. Prosthetic joint infections are a classical example of difficult to eradicate infections associated with biofilm. Most Prosthetic Joint Infection (PJI) cases are caused by staphylococcal species (\~70%) with an increasing number being antibiotic-resistant (MRSA). In the US, two-stage revision is the standard of care for replacement of an infected prosthetic joint, and is associated with substantial costs and prolonged immobility. TRL1068 is a fully human antibody that has been shown in pre-clinical studies to disrupt biofilm. TRL1068 targets a highly conserved epitope on the DNABII family of bacterial DNA binding proteins that includes histone-like (HU) and integration host factor (IHF) proteins of clinically relevant Gram-positive and Gram-negative bacteria. The DNABII epitope bound by TRL1068 has no homologs in the human proteome.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
15
A human IgG1κ (G1m1,17 (z,a); Km3 allotype) monoclonal antibody
University of Alabama
Birmingham, Alabama, United States
USC
Los Angeles, California, United States
UCLA
Santa Monica, California, United States
University of Florida
Gainesville, Florida, United States
Incidence of Abnormal Physical Examination Findings
clinically significant abnormal physical exam findings will be reviewed
Time frame: 16 weeks
Incidence of Abnormal Serum Chemistries and Hematology
clinically significant abnormal laboratory results will be reviewed
Time frame: 16 weeks
Incidence of Abnormal Vital Signs (Temperature)
clinically significant abnormal temperatures will be reviewed
Time frame: 16 weeks
Incidence of Abnormal Vital Signs (Blood Pressure)
clinically significant abnormal blood pressures will be reviewed
Time frame: 16 weeks
Incidence of Abnormal Vital Signs (Heart Rate)
clinically significant abnormal heart rates will be reviewed
Time frame: 16 weeks
Incidence of Adverse Events (AEs) and Serious Adverse Events (SAEs)
mortality and any other reported AEs and SAEs will be reviewed
Time frame: 24 weeks
Characterize the pharmacokinetics (PK) of a single IV infusion of TRL1068
Serum and synovial concentrations of TRL1068 will be determined by ELISA
Time frame: 16 weeks
Measure TRL1068 levels in synovial fluid on Day 8 and compare with plasma PK
Serum and synovial concentrations of TRL1068 will be determined by ELISA
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Gulfcoast Research Institute
Sarasota, Florida, United States
Phoenix Clinical Research
Tamarac, Florida, United States
Sinai Hospital of Baltimore
Baltimore, Maryland, United States
Houston Methodist Research Institute
Houston, Texas, United States
University of Virginia
Charlottesville, Virginia, United States
Time frame: 1 week
Assess the pharmacodynamics (PD) of TRL1068 (Colony Forming Units (CFUs) prosthesis)
Number of CFUs from sonicated prosthetic device
Time frame: 1 week
Assess the pharmacodynamics (PD) of TRL1068 (CFUs spacer)
Number of CFUs from sonicated orthopedic spacer
Time frame: 12 weeks
Assess the pharmacodynamics (PD) of TRL1068 (CRP)
Inflammatory biomarker CRP
Time frame: 16 weeks
Assess the pharmacodynamics (PD) of TRL1068 (ESR)
Inflammatory biomarker ESR
Time frame: 16 weeks
Assess the pharmacodynamics (PD) of TRL1068 (IL-6)
Inflammatory biomarker IL-6
Time frame: 16 weeks
Assess the pharmacodynamics (PD) of TRL1068 (IL-10)
Inflammatory biomarker IL-10
Time frame: 16 weeks
Assess the pharmacodynamics (PD) of TRL1068 (reinfection)
Assessment for reinfection including need for further surgical interventions and overall outcome
Time frame: 24 weeks
Assess the immunogenicity of TRL1068 as measured by anti-drug antibodies (ADAs)
Anti-drug antibodies (ADA), i.e. anti-TRL1068 antibodies in serum will determined by electrochemiluminescence assay.
Time frame: 16 weeks