Trial Review

Technical difficulties have been reported by some users of the search function and is being investigated by technical staff. Thank you for your patience and apologies for any inconvenience caused.

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been endorsed by the ANZCTR. Before participating in a study, talk to your health care provider and refer to this information for consumers
Trial details imported from ClinicalTrials.gov

For full trial details, please see the original record at https://clinicaltrials.gov/ct2/show/NCT03536559




Registration number
NCT03536559
Ethics application status
Date submitted
2/05/2018
Date registered
24/05/2018
Date last updated
3/04/2023

Titles & IDs
Public title
Nanocrystalline Gold to Treat Remyelination Failure in Chronic Optic Neuropathy In Multiple Sclerosis
Scientific title
A Phase 2, Randomized, DB-PC, Parallel Group Study for the Treatment of Visual Pathway Deficits In Chronic Optic Neuropathy to Assess the Efficacy, Safety, Tolerability and Pharmacokinetics of CNM-Au8 For Remyelination In Multiple Sclerosis
Secondary ID [1] 0 0
CNMAu8.201
Universal Trial Number (UTN)
Trial acronym
VISIONARY-MS
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Relapsing Remitting Multiple Sclerosis 0 0
Optic Neuropathy 0 0
Optic; Neuritis, With Demyelination 0 0
Condition category
Condition code
Eye 0 0 0 0
Diseases / disorders of the eye
Neurological 0 0 0 0
Other neurological disorders
Inflammatory and Immune System 0 0 0 0
Other inflammatory or immune system disorders

Intervention/exposure
Study type
Interventional
Description of intervention(s) / exposure
Treatment: Drugs - CNM-Au8
Treatment: Drugs - Placebo

Experimental: 15mg CNM-Au8 - 15mg suspension of clean-surfaced, faceted, gold nanocrystals in 60ml of sodium bicarbonate buffered water

Experimental: 30mg CNM-Au8 - 30mg suspension of clean-surfaced, faceted, gold nanocrystals in 60ml of sodium bicarbonate buffered water

Placebo Comparator: Placebo - The matched placebo to be used in this study will consist of water, sodium bicarbonate, and food coloring to match volume and color of the experimental treatments.


Treatment: Drugs: CNM-Au8
CNM-Au8 is a dark red/purple-colored liquid formulation consisting of a stable suspension of faceted clean surfaced elemental gold nanocrystals in buffered deionized water with a concentration of up to 0.5 mg/mL of gold. The formulation is buffered by sodium bicarbonate present at a concentration of 0.546 mg/mL. There are no other excipients. The drug product is formulated to be taken orally and will be provided in single dose HDPE containers. The study doses vary by the concentration of gold nanocrystals per milliliter in a volume of 60 mL.

Treatment: Drugs: Placebo
Placebo is liquid with identical color and taste
Intervention code [1] 0 0
Treatment: Drugs
Comparator / control treatment
Control group

Outcomes
Primary outcome [1] 0 0
Measures of Visual Function
Timepoint [1] 0 0
Baseline to 48 weeks
Secondary outcome [1] 0 0
Other Measures of Neurological Function
Timepoint [1] 0 0
Baseline up to 48 weeks

Eligibility
Key inclusion criteria
1. At least 18 years of age and up to 55 years of age (inclusive) at Screening.

2. Clinical diagnosis of Relapsing Multiple Sclerosis (meeting McDonald criteria, 2010)
who have had RMS no longer than 15 years from diagnosis.

3. Maximum Best Corrected High Contrast Visual Acuity (BC-HCVA) deficit on the Early
Treatment Diabetic Retinopathy Study (ETDRS) Chart of 20/200 (6/60 metric) in both
eyes.

a. BC-HCVA is defined as the last line on the Early Treatment Diabetic Retinopathy
Study (ETDRS) Chart that a patient is able to read three (3) or more letters
correctly.

4. Best Corrected Low Contrast Letter Acuity (BC-LCLA) (by 2.5% Sloan Chart) must be
20/40 (6/12 metric) (inclusive) or worse in the affected eye and 20/32 (6/9.5 metric)
or worse in the fellow eye; and the BC-LCLA must be worse than BC-HCVA for the
respective value in both eyes.

a. BC-LCLA is defined as the last line on the 2.5% Sloan Chart that a patient is able
to read three (3) or more letters correctly.

5. Retinal Nerve Fiber Layer (RNFL) thickness = 70 µm.

6. Stable disease activity based on the investigator's judgment over the previous 6
months.

7. All hematological parameters and biochemical parameters that fall outside the Within
Normal Limits range must be assessed as Not Clinically Significant (NCS) and deemed
stable or transient in nature.

8. Able to understand and give written informed consent.
Minimum age
18 Years
Maximum age
55 Years
Sex
Both males and females
Can healthy volunteers participate?
No
Key exclusion criteria
1. History of AQP4, MOG Ab(+) status, or = 3 segments lesion in the spinal cord.

2. Any diagnosis other than RMS that could explain the patient's signs and symptoms.

3. An acute optic neuritis episode within the prior 6 months.

4. Clinical relapse requiring systemic steroid treatment within the prior 3 months (pre-
treatment with systemic steroids during the administration of disease-modifying
therapies [DMT] may be allowed after discussion with the Sponsor's Medical Monitor but
must not be administered within 30 days of a planned VEP or MRI assessment).

5. Unstable treatment with a disease-modifying therapy (DMT) defined as a treatment
change within prior 3-months unless due to intolerability.

6. Current treatment with immunosuppressive or immunomodulatory therapy other than those
approved for the treatment of MS.

7. Any treatment with drugs known or suspected of producing retinal or optic nerve
toxicity including hydroxychloroquine, chloroquine, clofazimine, vigabatrin, or
ethambutol.

8. Any history of ophthalmological cause for retinal damage other than MS (e.g.
cataracts, uveitis, macular degeneration, macular exudate, macular edema, glaucoma,
severe astigmatism, ocular trauma, neuromyelitis optica, ischemic optic neuropathy,
congenital nystagmus, retinal detachment, amblyopia, optic disk drusen).

9. Severe refractive defects: refractive errors (-6 dioptres to +6 dioptres or more in
either eye, or axial eye length >26 mm), hypermetropia (> 6 dioptres; cylinder > 3
dioptres); or based on the investigators judgment any other ophthalmic diseases that
would confound the study results or assessment of Visual Evoked Potential (VEPs), Best
Corrected Visual Acuity (BCVA), Low Contrast Letter Acuity (LCLA), or Optical
Coherence Tomography (OCT).

10. History diabetic retinopathy or a previous diagnosis of Diabetes Mellitus or history
of prior impaired fasting glucose =126 mg/dL (or = 200 mg/dL after oral glucose
tolerance test).

11. History of human immunodeficiency virus (HIV), hepatitis C (HepC) virus antibody, or
hepatitis B (HepB) virus antibody.

12. History of gold allergy.

13. Patients taking stimulant medications (including: amphetamine, dextroamphetamine,
lisdexamfetamine, methylphenidate, or modafinil) who have not been on a stable dose
greater than or equal to 30 days. Changes to dose will not be allowed during the
course of the trial).

14. Patients taking clemastine fumarate, 4-aminopyridine (fampridine), or high dose Biotin
(>300 mg/day).

15. Females who have a positive serum pregnancy test result at Screening or Baseline, or
who are pregnant, breastfeeding, or planning to conceive during the study or within
180 days after study completion.

16. History or evidence of substance abuse or alcohol abuse within 5 years prior to
Screening, including alcoholism; or severe tobacco use (>1 pack/day).

17. Clinical history of toxic neuropathy (e.g., secondary to treatment with ethambutol,
isoniazid, linezolid, gentamycin, chloramphenicol, vincristine, or penicillamine).

18. Current enrollment in any other drug or device treatment study within 3 months prior
to Baseline. Participation in an observational non-interventional study (i.e., no drug
or device therapy) is not an exclusion criterion.

19. Inability to undergo any planned study procedures such as LCLA, VEP, MRI, or OCT;
history of severe hypersensitivity to gadolinium-DTPA or reduced renal clearance (GFR
must be = 45 mL/min at Screening), claustrophobia; or inability to comply with study
requirements based on Investigator judgment.

20. Patients with clinically significant hepatic or renal dysfunction or clinical
laboratory findings that would limit the interpretability of change in liver or kidney
function, or those with low platelet counts (< 150 x 10^9 per liter) or eosinophilia
(absolute eosinophil count of = 500 eosinophils per microliter) at Screening.

21. Based on the investigator's judgment, concurrent chronic or acute illness or unstable
medical condition that may deteriorate that could confound the results of safety
assessments, increase risk to the patient, or lead to difficulty complying with the
protocol; including severe disc edema or hemorrhage, any clinically significant
cardiac, endocrinological, hematological, hepatic, immunological, metabolic,
urological, pulmonary, neurological (any progressive neurological disorder other than
RRMS), dermatological, psychiatric (any untreated or unstable psychiatric disease
including depression, bipolar and psychosis), renal, severe allergic or anaphylactic
reactions, autoimmune, or other major confounding diseases.

22. Any history of previous malignancy, with the exception of basal cell carcinoma of the
skin or in situ carcinoma of the cervix, post documented full resections, with clean
margins.

23. Patient is considered a suicide risk in the opinion of the Investigator, has
previously made a suicide attempt, or is currently demonstrating active suicidal
ideation.

Study design
Purpose of the study
Treatment
Allocation to intervention
Randomised controlled trial
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Masking / blinding
Blinded (masking used)
Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
Intervention assignment
Parallel
Other design features
Phase
Phase 2
Type of endpoint/s
Statistical methods / analysis

Recruitment
Recruitment status
Terminated
Data analysis
Reason for early stopping/withdrawal
Other reasons
Date of first participant enrolment
Anticipated
Actual
23/11/2018
Date of last participant enrolment
Anticipated
Actual
Date of last data collection
Anticipated
Actual
12/07/2022
Sample size
Target
Accrual to date
Final
73
Recruitment in Australia
Recruitment state(s)
NSW,QLD,TAS,VIC
Recruitment hospital [1] 0 0
John Hunter Hospital - New Lambton Heights
Recruitment hospital [2] 0 0
Sydney Brain Mind Centre - Sydney
Recruitment hospital [3] 0 0
Princess Alexandria Hospital - Woolloongabba
Recruitment hospital [4] 0 0
Menzies Institute for Medical Research - Hobart
Recruitment hospital [5] 0 0
Alfred Health - Melbourne
Recruitment postcode(s) [1] 0 0
2305 - New Lambton Heights
Recruitment postcode(s) [2] 0 0
- Sydney
Recruitment postcode(s) [3] 0 0
4102 - Woolloongabba
Recruitment postcode(s) [4] 0 0
7000 - Hobart
Recruitment postcode(s) [5] 0 0
3004 - Melbourne
Recruitment outside Australia
Country [1] 0 0
United States of America
State/province [1] 0 0
Texas
Country [2] 0 0
Canada
State/province [2] 0 0
British Columbia

Funding & Sponsors
Primary sponsor type
Commercial sector/Industry
Name
Clene Nanomedicine
Address
Country
Other collaborator category [1] 0 0
Other
Name [1] 0 0
Clene Australia Pty Ltd
Address [1] 0 0
Country [1] 0 0

Ethics approval
Ethics application status

Summary
Brief summary
The objective of this trial is to assess the efficacy and safety of CNM-Au8 as a
remyelinating treatment for vision-impairing MS lesions in participants who have chronic
vision impairment as a result of Relapsing-Remitting Multiple Sclerosis. The primary endpoint
is to assess the efficacy and safety of CNM-Au8 as a remyelinating therapy in patients with
stable RMS. The secondary endpoint is Change in Functional Composite Responder Analysis Score
from Baseline to Week 24.
Trial website
https://clinicaltrials.gov/ct2/show/NCT03536559
Trial related presentations / publications
Public notes

Contacts
Principal investigator
Name 0 0
Heidi Beadnall, MD
Address 0 0
University of Sydney
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for public queries
Name 0 0
Address 0 0
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for scientific queries



Summary Results

For IPD and results data, please see https://clinicaltrials.gov/ct2/show/NCT03536559