Etanercept in Kawasaki Disease
- Full Text View
- Tabular View
- No Study Results Posted
- Disclaimer
- How to Read a Study Record
Purpose
The purpose of this study is to determine whether Etanercept (Enbrel) when used in conjunction with IVIG and aspirin, improves treatment response to IVIG in patients with Kawasaki Disease. Funding Source- FDA/OOPD
| Condition | Intervention | Phase |
|---|---|---|
|
Mucocutaneous Lymph Node Syndrome Kawasaki Disease |
Drug: Etanercept Drug: Placebo |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | A Randomized, Double Blind, Placebo Controlled Study of the Effects of Etanercept in Children Presenting With Kawasaki Disease |
- Determine if Etanercept at the dosing regimen of 0.8 mg/kg (50 mg max) SQ X3 doses given at weekly intervals, when used in conjunction with IVIG and aspirin will reduce the incidence of fever persistence or recrudescence. [ Time Frame: 42 days after initial dose ] [ Designated as safety issue: No ]
- Determine if the safety profile differs between the etanercept treated group and the placebo group. [ Time Frame: 42 days after initial dose ] [ Designated as safety issue: Yes ]
- Determine if Etanercept treatment alters the rate of coronary artery dilation and disease (CAD) defined by z-scores at 2 and 6 weeks after treatment. [ Time Frame: 42 days after initial dose ] [ Designated as safety issue: No ]
- Determine the pharmacokinetics of Etanercept in KD patients. [ Time Frame: 42 days after initial dose ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 220 |
| Study Start Date: | March 2009 |
| Estimated Study Completion Date: | March 2015 |
| Estimated Primary Completion Date: | January 2014 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Arm 1 -Etanercept
Drug - Treatment with Etanercept as adjunct to standard treatment with IVIG and aspirin
|
Drug: Etanercept
etanercept 0.8 mg/kg subcutaneously (max 50 mg) given three times, once a week for three weeks starting at initial diagnosis.
Other Name: Enbrel
|
|
Placebo Comparator: 2
Placebo
|
Drug: Placebo
Placebo 0.8 mg/kg subcutaneously (max 50 mg) given three times, once a week for three weeks starting at initial diagnosis.
|
Detailed Description:
Kawasaki Disease (KD) is a potentially life threatening acute vasculitis in children with a predilection for involvement of the coronary arteries. Aspirin and Intravenous gamma globulin (IVIG) are principally used for the treatment of the symptoms of Kawasaki Disease. Aspirin reduces inflammation and platelet formation, but has no effect in attenuating the development of coronary abnormalities. Although IVIG reduces inflammation and the prevalence of coronary artery abnormalities, it has a relatively high failure rate of 23-30%, warranting new treatment methods for Kawasaki Disease. We propose a placebo controlled double blinded randomized study to determine if etanercept 0.8 mg/kg subcutaneously (max 25 mg) given three times at weekly intervals starting at initial diagnosis is safe in this patient population and if it is a successful adjunct therapy with IVIG in reducing the incidence of persistent or recurrent fever.
Eligibility| Ages Eligible for Study: | 2 Months to 20 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Male Age 2 months to 20 years of age Female Age 2 months to 11 years of age
- Provision of Parental Consent
- Kawasaki Disease Presentation
Exclusion Criteria:
Laboratory Criteria: Any laboratory toxicity, at the time of the screening visit or at any time during the study that in the opinion of the Investigator would preclude participation in the study or:
- Platelet count < 100,000/mm3
- WBC count < 3,000 cells/mm3
- Hemoglobin, hematocrit, or red blood cell count outside 30% of the upper or lower limits of normal for the Lab
- Subject is currently enrolled in another investigational device or drug trial(s), or subject has received other investigational agent(s) within 28 days of baseline visit.
- Female subjects diagnosed with KD 12 years of age and older.
- Subjects who have known hypersensitivity to Enbrel or any of its components or who is known to have antibodies to etanercept
- Prior or concurrent cyclophosphamide therapy
- Prior treatment with any TNF alpha antagonist or steroid within 48 hours prior to initiation of IVIG
- Concurrent sulfasalazine therapy
- Active severe infections within 4 weeks before screening visit, or between the screening and baseline visits.
- SLE, history of multiple sclerosis, transverse myelitis, optic neuritis, or chronic seizure disorder
- Known HIV-positive status or known history of any other immuno-suppressing disease.
- Any mycobacterial disease or high risk factors for tuberculosis, such as family member with TB or taking INH
- Untreated Lyme disease
- Severe comorbidities (diabetes mellitus requiring insulin, CHF of any severity, MI, CVA or TIA within 3 months of screening visit, unstable angina pectoris, uncontrolled hypertension (sitting systolic BP > 160 or diastolic BP > 100 mm Hg), oxygen-dependent severe pulmonary disease, history of cancer within 5 years [other than resected cutaneous basal or squamous cell carcinoma or in situ cervical cancer])
- Exposure to hepatitis B or hepatitis C or high risk factors such as intravenous drug abuse in patient's mother, or history of jaundice (other than neonatal jaundice). SLE, history of multiple sclerosis, transverse myelitis, optic neuritis or chronic seizure disorder.
- Use of a live vaccine (Measles Mumps Rubella or Varicella) 30 days prior to or during this study.
- Any condition judged by the patient's physician to cause this clinical trial to be detrimental to the patient
- History of non-compliance with other therapies
- Must not have received immunosuppressive agents for at least three months prior to enrollment.
Contacts and Locations| Contact: Michael A Portman, MD | (206) 884-1014 | michael.portman@seattlechildrens.org |
| Contact: Miriam Silva, MD/BS | (206) 884-5153 | miriam.silva@seattlechildrens.org |
| United States, New York | |
| Montefiore Medical Center | Recruiting |
| Bronx, New York, United States, 10467 | |
| Contact: Nadine Choueiter, MD 718-741-2539 nchoueit@montefiore.org | |
| Principal Investigator: Nadine Choueiter, MD | |
| Feinstein Institute for Medical Rsearch | Recruiting |
| New Hyde Park, New York, United States, 11040 | |
| Contact: Sujatha Rajan, MD 718-470-3415 surajan@nshs.edu | |
| Contact: Nancy Stellato, RN 718-470-3415 nstellat@NSHS.edu | |
| Principal Investigator: Deborah Mensch, MD | |
| Columbia University Medical Center | Recruiting |
| New York, New York, United States, 10032 | |
| Contact: Lisa F Imundo, MD 212-305-9304 lfil@columbia.edu | |
| Contact: Sarah Warnock 212-305-1554 sw2604@columbia.com | |
| Principal Investigator: Lisa F Imundo, MD | |
| United States, Texas | |
| Texas Children's Hospital | Recruiting |
| Houston, Texas, United States, 77030 | |
| Contact: Carolyn A Altman, MD 832-826-5682 caaltman@texaschildrens.org | |
| Contact: Debra Griffin, RN 832-826-5864 dagriffi@mcm.tmc.edu | |
| Principal Investigator: Carolyn A. Altman, MD | |
| United States, Utah | |
| Primary Children's Medical Center | Completed |
| Salt Lake City, Utah, United States, 84113 | |
| United States, Washington | |
| Seattle Children's Hospital | Recruiting |
| Seattle, Washington, United States, 98105 | |
| Contact: Michael A Portman, MD 206-884-1014 michael.portman@seattlechildrens.org | |
| Contact: Miriam Silva, MD 206-884-5153 miriam.silva@seattlechildrens.org | |
| Principal Investigator: Michael A Portman, MD | |
| United States, Wisconsin | |
| Children's Hospital of Wisconsin | Recruiting |
| Milwaukee, Wisconsin, United States, 53201 | |
| Contact: Dominic Co, MD 414-266-6700 dco@mcw.edu | |
| Contact: Marsha Malloy, RN 414-266-6792 mmalloy@mcw.edu | |
| Principal Investigator: Edward Kilpatrick, DO | |
| Canada, Quebec | |
| Sainte-Justine Hospital | Recruiting |
| Montreal, Quebec, Canada, H3T 1C5 | |
| Contact: Nagib Dahdah, MD 514-345-4931 ext 5403 nagib.dahdah.hsj@ssss.gouv.qc.ca | |
| Contact: Julie Briere, RN 514-345-4931 ext 4573 julie.briere@recherche-ste-justine.qc.ca | |
| Principal Investigator: Nagib Dahdah, MD | |
| Principal Investigator: | Michael A Portman, MD | Seattle Children's Hospital |
More Information
No publications provided by Seattle Children's Hospital
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| Responsible Party: | Michael Portman, Cardiologist, Seattle Children's Hospital |
| ClinicalTrials.gov Identifier: | NCT00841789 History of Changes |
| Other Study ID Numbers: | SEA-12652, FD003526 |
| Study First Received: | February 10, 2009 |
| Last Updated: | April 24, 2013 |
| Health Authority: | United States: Food and Drug Administration |
Keywords provided by Seattle Children's Hospital:
|
Etanercept |
Additional relevant MeSH terms:
|
Mucocutaneous Lymph Node Syndrome Vasculitis Vascular Diseases Cardiovascular Diseases Lymphatic Diseases Skin Diseases, Vascular Skin Diseases TNFR-Fc fusion protein Anti-Inflammatory Agents, Non-Steroidal Analgesics, Non-Narcotic Analgesics |
Sensory System Agents Peripheral Nervous System Agents Physiological Effects of Drugs Pharmacologic Actions Anti-Inflammatory Agents Therapeutic Uses Antirheumatic Agents Gastrointestinal Agents Immunologic Factors Immunosuppressive Agents Central Nervous System Agents |
ClinicalTrials.gov processed this record on May 23, 2013