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Trial registered on ANZCTR
Registration number
ACTRN12624000664549
Ethics application status
Approved
Date submitted
5/04/2024
Date registered
24/05/2024
Date last updated
30/08/2024
Date data sharing statement initially provided
24/05/2024
Type of registration
Prospectively registered
Titles & IDs
Public title
CNT201 Phase 1/2 study in Adults with Dupuytren’s Contracture
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Scientific title
A Phase 1/2, Multicenter, Dose Escalating, Dose Expanding, Adaptive Study to Assess Safety, Tolerability, Efficacy and Pharmacokinetics of Collagenase CNT201 in Adult Participants with Dupuytren’s Contracture
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Secondary ID [1]
311862
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DC2201
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Dupuytren’s Contracture
333410
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Condition category
Condition code
Human Genetics and Inherited Disorders
330090
330090
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0
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Other human genetics and inherited disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Interventional Product (IP): CNT201 recombinant collagenase
Dosage form: Injectable Solution
Mode of administration: Intralesional injection by a syringe to a single cord
In Step 1 (Dose escalation), eligible participants will receive single injection of the designated CNT201 of 1 of 4 dose levels (with a provisional 5th dose level) on Day 1 of a 28 day treatment cycle with additional follow up until Day 57.
A range of doses starting at 0.1 mg/kg up to 0.8 mg/kg or lower, as determined by the safety results, will be studied across up to 5 participant cohorts.
Dose escalation to next higher dose cohort will be made by the safety review committee.
4 participants will be enrolled in Cohort 1 and 8 participants in all other cohorts.
The SRC might recommend an additional optional fifth cohort that is a de-escalating dose lower than Cohort 1 or any dose between Cohort 1 and Cohort 4 in Step 1 (dose escalation). This optional fifth dose would be lower than the last completed highest dose level if emerging data suggests that exploring an intermediate dose before proceeding to Step 2 is warranted. However, it should not exceed the last completed highest dose level (i.e. optional fifth cohort will be 0.5mg/cord, if Cohort 3 (0.6mg/cord) was completed. And optional fifth cohort will be 0.7mg/cord, if Cohort 4 (0.8mg/cord) was completed). We will not escalate higher than high dose (0.8mg/cord)..
Only authorized study center staff will supply and administer the study treatment.
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Intervention code [1]
328324
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Treatment: Drugs
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Step 1 (Dose escalation) Safety and tolerability of CNT201
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Assessment method [1]
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Step 1 (Dose escalation) : Incidence of TEAEs (treatment emergent adverse events), SAEs (serious adverse events), and AESIs (adverse events of special intrest) by severity
Treatment-emergent AEs will be coded using the latest version of Medical Dictionary for Regulatory Activities (MedDRA)
AESIs are graded according to CTCAE v5.0
As this is a first in human trial, there are no known examples of adverse reactions/events, however, the most closely related product on the market, Xiaflex has the following very common adverse reaction profile: lymphadenopathy, lymph node pain, paraesthesia, hypoesthesia, burning sensation, dizziness, headaches, nausea, blood blister, rash, erythema, hyperhidrosis, arthralgia, axillary mass, joint sweeling, myalgia, axillary pain, inflammation, injection site warmth, erythema, inflammation, vesicles or pruritus, swelling, pruritus, ecchymosis, pain in extremity, peripheral oedema, injection site haemorrhage, pain or swelling, tenderness, contusion, skin laceration.
These will be assessed by a safety review committee, which will sit at the conclusion of each cohort. For serious adverse reactions, adverse events of special interest, an independent data monitoring committee will convene and make decisions based on patient safety and the data available.
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Timepoint [1]
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Step 1 (Dose escalation) Assessments will be conducted on Screening, Day 1 (before injection, baseline, 15 min, 30 min, 45 min, 1 hr, 2 hr, 4 hr and 6 hrs), Day 2, Day 3, Day 8, Day 15, Day 29 and Day 57 post dose
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Primary outcome [2]
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Step 1 (Dose escalation) Safety and tolerability of CNT201
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Assessment method [2]
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Step 1 (Dose escalation) Changes from baseline in Vital signs (blood pressure, pulse rate, respiratory rate, and body temperature)
Blood pressure will be taken using a manual sphygmomanometer, while pulse rate will be measured by a manual oximeter.
The participant’s respiratory rate will be measured by a manual count and the participant’s body temperature will be measured by a digital thermometer.
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Timepoint [2]
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Step 1 (Dose escalation) At screening, predose on Day 1, post dose on Day 1, Day 2, Day 3, Day 8, Day 15, Day 29, Day 57 (end of study)
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Primary outcome [3]
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Step 1 (Dose escalation) Safety and tolerability of CNT201
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Assessment method [3]
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Step 1 (Dose escalation) Changes from baseline in ECGs
ECG will be obtained using a automated ECG machine. Automated is used to distinguish from a manual device. For example, an ECG machine that automatically calculates the heart rate and measures PR, QRS, QT, and QTc intervals, as opposed to physician manual calculation.
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Timepoint [3]
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Step 1 (Dose escalation) At screening and on Day 1 post dose
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Secondary outcome [1]
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Step 1 (Dose escalation) - Primary Outcome 4- Safety and tolerability of CNT201
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Assessment method [1]
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Step 1 (Dose escalation) - Primary Outcome 4: Changes from baseline of Laboratory parameters (clinical chemistry, hematology, coagulation, and urinalysis)
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Timepoint [1]
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Step 1 (Dose escalation)- Primary Outcome 4 - At screening, Predose on Day 1 and Day 29 post dose
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Secondary outcome [2]
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Step 1 (Dose escalation) -Primary Outcome 5- Safety and tolerability of CNT201
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Assessment method [2]
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Step 1 (Dose escalation)-Primary Outcome 5- Changes from baseline in Physical examination (including injection site reactions)
-Participant’s height will be measured by a stadiometer and the participant’s weight will be measured by a digital scale.
A complete physical examination will include, at a minimum, assessments of the cardiovascular, respiratory, gastrointestinal, neurological systems and lymph nodes (axillary lymphadenopathy). Height (Screening visit only) and weight (Screening visit and before each study treatment administration) will also be measured and recorded. Investigators should pay special attention to clinical signs related to DC and any type of injection site reaction by means of injection site evaluations.
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Timepoint [2]
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Step 1 (Dose escalation)- Primary Outcome 5- At screening, Predose on Day 1, Post dose on Day 29, Day 57 (EOS)
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Secondary outcome [3]
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Step 1 (Dose escalation)- Primary outcome 6- Assess the efficacy of CNT201 in reducing the degree of contracture after injection.
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Assessment method [3]
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Step 1 (Dose escalation) - Primary Outcome 6- Proportion of participants who achieve reduction in contracture to within 0-5 degree of normal extension within 29 days after the first injection
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Timepoint [3]
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Step 1 (Dose escalation) - Primary Outcome 6 -At screening, pre dose on Day 1, Post dose on Day 1, Day 6, Day 2, Day 3, Day 8, Day 15, Day 29 and Day 57 (EoS)
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Secondary outcome [4]
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Step 1 (Dose escalation) : Assess the change in the primary joint after the study treatment injection
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Assessment method [4]
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Step 1 (Dose escalation) : Assessed by proportion of participants who achieve clinical improvement, defined as a less than or equal to 50% reduction from Day 1 in degree of contracture after an injection.
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Timepoint [4]
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Step 1 (Dose escalation): At Screening, Predose , Post dose on Day 1 (1 hour, 6 hours), Day 2, Day 3, Day 8, Day 15, Day 29, and Day 57 (EoS)
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Secondary outcome [5]
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Step 1 (Dose escalation) : Assess the change in the primary joint after the study treatment injection
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Assessment method [5]
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Step 1 (Dose escalation) : Assessed by mean percent change in degree of contracture
Finger joint contracture will be measured using a hand goniometer to measure the range of motion of finger joints (MP and interphalangeal). The head has 2 opposing 180° scales which are marked in 5° increments. Finger goniometry will be used to measure range of motion to determine the degree of finger extension and evaluate the proportion of participants with clinical improvement, change in degree of contracture, change in range of motion, and time to clinical success.
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Timepoint [5]
434094
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Step 1 (Dose escalation): At Screening, Predose , Post dose on Day 1 (1 hour, 6 hours), Day 2, Day 3, Day 8, Day 15, Day 29, and Day 57 (EoS)
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Secondary outcome [6]
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Step 1 (Dose escalation) : Clinical Evaluation in the primary joint after study treatment injection
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Assessment method [6]
434096
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Step 1 (Dose escalation) : Assesed by time to clinical success which is determined according to the study day on which the participant's treated joint contracture is first found to be less than or equal to 5 degrees .
Finger joint contracture will be measured using a hand goniometer to measure the range of motion of finger joints (MP and interphalangeal). The head has 2 opposing 180° scales which are marked in 5° increments. Finger goniometry will be used to measure range of motion to determine the degree of finger extension and evaluate the proportion of participants with clinical improvement, change in degree of contracture, change in range of motion, and time to clinical success.
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Timepoint [6]
434096
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Step 1 (Dose escalation): At Screening, Predose , Post dose on Day 1 (1 hour, 6 hours), Day 2, Day 3, Day 8, Day 15, Day 29, and Day 57 (EoS)
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Secondary outcome [7]
434097
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Step 1 (Dose escalation) : Assess the change in the primary joint after the study treatment injection
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Assessment method [7]
434097
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Step 1 (Dose escalation) : Assessed by change in range of motion ( full extension-joint extended away from the palm )
Finger goniometry will be used to measure range of motion to determine the degree of finger extension and evaluate the proportion of participants with clinical improvement, change in degree of contracture, change in range of motion, and time to clinical success.
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Timepoint [7]
434097
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Step 1 (Dose escalation): At Screening, Predose , Post dose on Day 1 (1 hour, 6 hours), Day 2, Day 3, Day 8, Day 15, Day 29, and Day 57 (EoS)
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Secondary outcome [8]
434312
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Step 1 (Dose escalation) : Assess the change in the primary joint after the study treatment injection
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Assessment method [8]
434312
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Step 1 (Dose escalation) : Assessed by Physician Global assessment of treatment satisfaction.
Treatment satisfaction will be rated using a 5-point Likert type Scale
1- Very satisfied
2- Satisfied
3 - neither satisfied nor dissatisfied
4- dissatisfied
5- very dissatisfied
These questionnaires were designed for the study, and don’t have a specific source for them.
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Timepoint [8]
434312
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On Day 1 (Pre-dose), Day 29 and Day 57 (EoS)
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Secondary outcome [9]
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Step 1 (Dose escalation) : Assess the change in the primary joint after the study treatment injection
Finger goniometry will be used to measure range of motion to determine the degree of finger extension and evaluate the proportion of participants with clinical improvement, change in degree of contracture, change in range of motion, and time to clinical success.
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Assessment method [9]
435022
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Step 1 (Dose escalation) : Assessed by change in range of motion (full flexion- joint flexed towards the palm)
Finger goniometry will be used to measure range of motion to determine the degree of finger extension and evaluate the proportion of participants with clinical improvement, change in degree of contracture, change in range of motion, and time to clinical success.
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Timepoint [9]
435022
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Step 1 (Dose escalation): At Screening, Predose , Post dose on Day 1 (1 hour, 6 hours), Day 2, Day 3, Day 8, Day 15, Day 29, and Day 57 (EoS)
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Secondary outcome [10]
435023
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Step 1 (Dose escalation) : Assess the change in the primary joint after the study treatment injection
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Assessment method [10]
435023
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Step 1 (Dose escalation) : Assessed by the difference in change in range of motion (full flexion minus full extension)
Finger goniometry will be used to measure range of motion to determine the degree of finger extension and evaluate the proportion of participants with clinical improvement, change in degree of contracture, change in range of motion, and time to clinical success.
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Timepoint [10]
435023
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Step 1 (Dose escalation): At Screening, Predose , Post dose on Day 1 (1 hour, 6 hours), Day 2, Day 3, Day 8, Day 15, Day 29, and Day 57 (EoS)
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Secondary outcome [11]
435026
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Step 1 (Dose escalation) : Assess the change in the primary joint after the study treatment injection
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Assessment method [11]
435026
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Step 1 (Dose escalation) : Assessed by Participant Global assessment of treatment satisfaction.
Treatment satisfaction will be rated using a 5-point Likert type Scale
1- Very satisfied
2- Satisfied
3 - neither satisfied nor dissatisfied
4- dissatisfied
5- very dissatisfied
These questionnaires were designed for the study, and don’t have a specific source for them.
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Timepoint [11]
435026
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On Day 1 (Pre-dose), Day 29 and Day 57 (EoS)
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Secondary outcome [12]
435027
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Step 1 (Dose escalation) : Assess the change in the primary joint after the study treatment injection
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Assessment method [12]
435027
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Step 1 (Dose escalation) : Assessed by Physician global assessment of disease severity.
Disease/contracture severity will be rated using a 4-point scale
1- normal
2- mild
3- moderate
4- severe
These questionnaires were designed for the study, and don’t have a specific source for them.
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Timepoint [12]
435027
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On Day 1 (Pre-dose), Day 29 and Day 57 (EoS)
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Secondary outcome [13]
435028
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Step 1 (Dose escalation) : Assess the change in the primary joint after the study treatment injection
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Assessment method [13]
435028
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Step 1 (Dose escalation) : Assessed by Participant Global assessment of disease severity
Disease/contracture severity will be rated using a 4-point scale
1- normal
2- mild
3- moderate
4- severe
These questionnaires were designed for the study, and don’t have a specific source for them.
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Timepoint [13]
435028
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On Day 1 (Pre-dose), Day 29 and Day 57 (EoS)
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Eligibility
Key inclusion criteria
1. Men and women, 18 to 75 years of age, inclusive.
2. Women to be included in the study are postmenopausal or agree to use contraception throughout the course of the study. Men should also agree to use a contraceptive method throughout the course of the study.
3. Participants with a diagnosis of primary DC, with a fixed flexion deformity of at least 1 finger, other than the thumb, that has a contracture at least 20°, but not greater than 100°, for metacarpophalangeal (MP) not greater than 80° for Proximal interphalangeal (PIP) joints, caused by a palpable cord.
4. Participants who have a positive Table Top Test, defined as the inability to simultaneously place the affected finger(s) and palm flat against a table top.
5. Participants who are naive to CNT201 treatment.
6. Participants who are judged to be in good health, based upon the results of a medical history, physical examination, and safety laboratory profile.
7. Participants who are willing to voluntarily sign and date the Informed Consent Form (ICF) approved by the Institutional Review Board/Independent Ethics Committee (IRB/IEC).
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Minimum age
18
Years
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Maximum age
75
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. Participants previously exposed to collagenase Clostridium histolyticum for treatment of Dupuytren’s disease (Xiaflex, Xiapex®).
2. Participants who exhibit a recurrent DC affecting the selected primary joint, along with a history of other treatments for advanced Dupuytren’s disease, including surgery (fasciectomy or fasciotomy), needle aponeurotomy/fasciotomy.
3. Participants who have received injection of verapamil, steroids and/or interferon on the selected primary joint within 90 days before the first dose of study treatment.
4. Participants with a chronic muscular, neurological, or neuromuscular disorder that affects the hands, or other medical condition which in the Investigator’s opinion will make the participant unsuitable for enrollment in the study.
5. Participants who have a known recent history of stroke, bleeding, a disease process that affected the hands, or other medical condition (e.g., breast cancer patients with enlarged lymph nodes etc), or history of alcoholism or drug abuse, which in the Investigator’s opinion, would make the participant unsuitable for enrollment in the study.
6. Participants with active cardiovascular disease including clinically significant arrhythmias or prolonged QT interval (QTc greater than 450 msec for males and greater than 470 msec for females).
7. Participants with secondary DC due to diabetes or liver disease.
8. Participants with osteoarthritis or rheumatoid arthritis in the hands, determined by the Investigator based on their review, clinical examination, or X-ray assessment.
9. Participants who are human immunodeficiency virus (HIV) positive.
10. Participants who have an active infection of tuberculosis (TB).
11. Participants who have a known allergic response to collagenase or any other excipient of CNT201.
12. Participants who have received a doxycycline or tetracycline derivative within 14 days before the beginning of the study (tetracycline derivatives may inhibit the collagenolytic
activity of mammalian collagenase homologs).
13. Participants who have received an anticoagulant (except aspirin less than or equal to 150 mg/day) within 7 days before the start of the study.
14. Female participants who are nursing or pregnant, or plan to become pregnant during the study treatment stage of the study.
15. Participants who have been treated with any investigational drug within 30 days of first dose of study treatment
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
Phase 1 / Phase 2
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
23/07/2024
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Actual
23/07/2024
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Date of last participant enrolment
Anticipated
17/05/2025
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Actual
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Date of last data collection
Anticipated
18/07/2025
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Actual
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Sample size
Target
36
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Accrual to date
1
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Final
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Recruitment in Australia
Recruitment state(s)
QLD
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Recruitment hospital [1]
27049
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Griffith University Clinical Trials Unit - Southport
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Recruitment postcode(s) [1]
43118
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4222 - Griffith University
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Funding & Sponsors
Funding source category [1]
316205
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Commercial sector/Industry
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Name [1]
316205
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Connext ANZ Pty Ltd.
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Address [1]
316205
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Country [1]
316205
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Australia
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Primary sponsor type
Commercial sector/Industry
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Name
Connext Co., Ltd
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Address
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Country
Australia
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Secondary sponsor category [1]
318389
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Commercial sector/Industry
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Name [1]
318389
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Novotech (Australia) Pty Ltd.
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Address [1]
318389
0
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Country [1]
318389
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
315022
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Bellberry Human Research Ethics Committee A
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Ethics committee address [1]
315022
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https://bellberry.com.au/
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Ethics committee country [1]
315022
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Australia
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Date submitted for ethics approval [1]
315022
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12/04/2024
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Approval date [1]
315022
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21/05/2024
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Ethics approval number [1]
315022
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2024-04-447
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Summary
Brief summary
Study details This registration is for Step 1 of a 2 step study investigating CNT201. CNT201 is a recombinant collagenase product being developed by the Sponsor, which is being studied for the treatment of Dupuytren’s Contracture (DC) This is an adaptive clinical study design containing 2 steps (Dose escalation and Dose expansion). Step 1 (dose escalation) uses an open-label design. Participants will be enrolled to a dose cohort with the CNT201 dose to be administered determined by the cohort to which the participant is enrolled; Afte a screening period of upto 30 days, eligible participants will be enrolled into 1 of 4 cohorts (provisional 5th cohort) and will be administered a single dose of CNT201 at 1 of 4 CNT201 dose levels: First-, low-, intermediate-, or high-dose (Cohort 1 to Cohort 4, respectively) within a treatment cycle. The treatment period will consist of an intralesional injection of CNT201 (Day 1), followed by a series of safety, efficacy, PK, and immunogenicity evaluations for 28 days (until Day 29) with primary efficacy assessed on Day 29 with an additional 28 days of safety follow-up thereafter (until Day 57). If there are no safety concerns on Day 57 as assessed by the investigator, Day 57 will serve as the End-of-Study (EOS) visit for Step 1. Cohort 1 will enroll 4 participants; all other cohorts will enroll 8 participants.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Randipsingh Bindra
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Address
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Griffith University Clinical Trials Unit, Level 4, Parklands Drive, Southport, Queensland Australia 4222
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Country
133454
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Australia
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Phone
133454
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+617 56874860
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Fax
133454
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Email
133454
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[email protected]
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Contact person for public queries
Name
133455
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Suntae Kim
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Address
133455
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Connext Co., Ltd., Suite 505, 76 Dongnae-ro, Dong-gu Daegu, Republic of Korea 41061
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Country
133455
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Korea, Republic Of
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Phone
133455
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+821056822489
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Fax
133455
0
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Email
133455
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[email protected]
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Contact person for scientific queries
Name
133456
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Suntae Kim
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Address
133456
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Connext Co., Ltd., Suite 505, 76 Dongnae-ro, Dong-gu Daegu, Republic of Korea 41061
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Country
133456
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Korea, Republic Of
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Phone
133456
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+821056822489
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Fax
133456
0
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Email
133456
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
Download to PDF