Comparison Between Rituximab Treatment and General Corticotherapy Treatment in Patients With Pemphigus (Rituximab 3)
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Purpose
Pemphigus is a severe and sometimes life-threatening disease with a mortality rate between 5 and 10 percent depending on the severity of disease and age of patients.
The standard of care is high doses of corticosteroids (CS) (usually, prednisone, 1 to 1.5. mg/kg/day, which are often associated with immunosuppressive drugs i.e., azathioprine, mycophenolate mofetil, cyclophosphamide, cyclosporine, although only one randomised study has demonstrated the superiority of the combination of corticosteroids and immunosuppressive drugs as compared to corticosteroids alone (9). Because of the low frequency of the disease, control trials are difficult to conduct. Evaluation of the different treatment regimens proposed, i;e; corticosteroids alone, CS and immunosuppressive drugs, IV immunoglobulins or new therapeutic regimens such as rituximab (an anti-CD20 monoclonal antibody directed against B- lymphocytes) or immunoadsorbtion.
| Condition | Intervention | Phase |
|---|---|---|
|
Pemphigus Disease |
Drug: General Corticotherapy |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Comparison Between Monoclonal Antibody CD20 Treatment (Rituximab (mabthéra))and General Corticotherapy Treatment in Patients With Pemphigus |
- Number of patients with pemphigus controlled 24 months after the start of Rituximab treatment [ Time Frame: 2 years ] [ Designated as safety issue: No ]
- Number of patients with pemphigus with both cutaneous and mucosal lesions healing after 6 months of rituximab treatment [ Time Frame: 6 months ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 90 |
| Study Start Date: | July 2009 |
| Estimated Study Completion Date: | August 2016 |
| Estimated Primary Completion Date: | December 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Experimental: Rituximab |
Drug: General Corticotherapy
for patients with severe pemphigus : rituximab Arm : 1mg/kg/d for 1 month, then 0.75 mg/kg/d for 1 month, then 0.5 mg/kg/d for 1 month, then 0.3 mg/kg/d for 1 month, then 0.2 mg/kg/d for 1 month, then 0.1 mg/kg/d for 1 month general corticotherapy Arm : 1.5mg/kg/d for 1 month, then 1.25mg/kg/d for 1 month, then 1mg/kg/d for 1 month, then 0.75 mg/kg/d for 1 month, then 0.5 mg/kg/d for 3 months, then 0.3 mg/kg/d for 3 months, then 0.2 mg/kg/d for 4 months, then 0.1 mg/kg/d for 4 months, for patients with moderated pemphigus : rituximab Arm : 0.5mg/kg/d for 1 month, then 0.30 mg/kg/d for 1 month, then 0.2 mg/kg/d for 1 month, general corticotherapy Arm : 1mg/kg/d for 1 month, then 0.75mg/kg/d for 1 month, then 0.5mg/kg/d for 2 months, then 0.3 mg/kg/d for 2 months, then 0.2 mg/kg/d for 3 months, then 0.1 mg/kg/d for 3 months,
|
Eligibility| Ages Eligible for Study: | 18 Years to 80 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- age >=18 and <= 80years
- consent obtained from patient
- effective female contraceptive method for women in procreate age
- new case of pemphigus vulgaris (PV) or pemphigus foliaceus (PF)
Exclusion Criteria:
- pemphigus vulgaris (PV) or pemphigus foliaceus (PF) treated
- pregnant woman or nursing mother
- woman able to have a baby and without contraception during the clinical trial period
- age < 18 or > 80
- karnovsky < 50%
- serious antecedents of allergy or anaphylactic reaction with human monoclonal antibody
- patient with depletion lymphocytic treatment in the next month
- unstable angina or ischemic heart disease
- cardiac insufficiency
- cardiac rhythm trouble uncontrolled
- positive HIV serology
- positive hepatitis B and / or C serology
- no consent
Contacts and Locations| Contact: Pascal JOLY, Professor | (33)232888990 | pascal.joly@chu-rouen.fr |
| Contact: philippe MUSETTE, Professor | (33)232888990 | philippe.musette@chu-rouen.fr |
| France | |
| CHU de Rouen - Hôpitaux de Rouen | Recruiting |
| Rouen, Seine Maritime, France, 76031 | |
| Contact: Helene , LAPEYRE (33)232888990 helene.lapeyre@chu-rouen.fr | |
| Sub-Investigator: Sophie DUVERT LEHAMBRE, Doctor | |
| Principal Investigator: Pascal JOLY, Professor | |
| Sub-Investigator: Philippe MUSETTE, Professor | |
| Sub-Investigator: helene LAPEYRE, Doctor | |
| Principal Investigator: | Pascal JOLY, Professor | Clinique Dermatologique - Hôpitaux de Rouen |
More Information
No publications provided
| Responsible Party: | University Hospital, Rouen |
| ClinicalTrials.gov Identifier: | NCT00784589 History of Changes |
| Other Study ID Numbers: | 2008/068/HP |
| Study First Received: | November 3, 2008 |
| Last Updated: | June 22, 2012 |
| Health Authority: | France: Afssaps - Agence française de sécurité sanitaire des produits de santé (Saint-Denis) |
Keywords provided by University Hospital, Rouen:
|
Corticothérapy Rituximab therapeutic efficacity therapeutic tolerance |
Additional relevant MeSH terms:
|
Pemphigus Skin Diseases, Vesiculobullous Skin Diseases Autoimmune Diseases Immune System Diseases Rituximab |
Immunologic Factors Physiological Effects of Drugs Pharmacologic Actions Antirheumatic Agents Therapeutic Uses Antineoplastic Agents |
ClinicalTrials.gov processed this record on May 23, 2013