Ulcerative Colitis Clinical Trial
Official title:
PHASE 2 STUDY OF DEXAMETHASONE 21-PHOSPHATE LOADED INTO AUTOLOGOUS ERYTHROCYTES IN STEROID-DEPENDENT ULCERATIVE COLITIS PATIENTS
The purpose of this study is to investigate the efficacy and safety of erythrocyte-mediated delivery of dexamethasone in steroid-dependent ulcerative colitis patients
Medical treatment of patients with ulcerative colitis (UC) presents a constant challenge.
Corticosteroids are effective in the majority of patients, but benefits are offset by
adverse events. For steroid-dependent patients therapeutic choices are limited to
azathioprine/6-mercaptopurine, methotrexate and infliximab; however, 25% of more patients do
not respond, become intolerant, or have contraindications (e.g. history of neoplasia) to
these drugs.
A novel method of corticosteroids delivery by loading dexamethasone 21-phosphate into red
blood cells has been validated. Owing to their long life span in the circulation and the
capability of their cellular membrane to be opened and resealed in appropriate conditions,
erythrocytes are excellent drug carriers. An ideal drug to be encapsulated into erythrocytes
is Dex 21-P, a biologically inactive compound which undergoes dephosphorylation by
intra-erythrocyte enzymes releasing the active metabolite, dexamethasone, by simple passive
diffusion through cell membranes. In a previous pilot study in a cohort of steroid-dependent
patients with inactive inflammatory bowel disease, Dexamethasone 21-phosphate loaded into
autologous erythrocytes allowed to complete withdrawal of systemic steroids, and the overall
cumulative exposure to corticosteroids from Dex 21-P-encapsulated erythrocytes (about 5-10
mg per month) was far less than conventional corticosteroids, and this translated into a
lower rate of steroid-related events.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Treatment
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