Subcutaneous Immunoglobulin Treatment of Patients With Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP)
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Purpose
The purpose of this study is to determine whether subcutaneous immunoglobulin given in small doses, is effective in maintaining the force, in patients with chronic inflammatory demyelinating polyradiculoneuropathy compared with placebo (saline infusions), and intravenous immunoglobulin.
| Condition | Intervention | Phase |
|---|---|---|
|
Polyradiculoneuropathy, Chronic Inflammatory Demyelinating |
Drug: Subcutaneous immunoglobulin |
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: | Randomised, Double-blinded, Placebo-controlled Trial of Subcutaneous Immunoglobulin Treatment in Patients With Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP) |
- Strength assessed by isokinetic strength measurements, in the active treatment group compared with the placebo group. [ Time Frame: The study period is 98 days. Isokinetic strength will be measured on day 14, 28, 84 and 98 of the study period. If there is a drop-out before day 84, the strength measurement will take place on this day, and the last two measurements will be left out. ] [ Designated as safety issue: No ]
- Efficacy and feasibility of subcutaneous immunoglobulin infusions. [ Time Frame: Feasibility will be recorded continously in a patient diary and in the CRF (case report form), and efficacy will be calculated at the end of the study, after approximately three months. ] [ Designated as safety issue: Yes ]
| Enrollment: | 30 |
| Study Start Date: | April 2010 |
| Study Completion Date: | November 2011 |
| Primary Completion Date: | November 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Active Comparator: Subcutaneous immunoglobulin |
Drug: Subcutaneous immunoglobulin
The subcutaneous immunoglobulin is infused in the subcutaneous tissue on the abdomen twice or thrice a week, with a maximal speed of 2 mL/h. Every time 20 mL is infused, the needle is removed to a new place.
Other Name: Subcuvia®
|
| Placebo Comparator: Saline |
Drug: Subcutaneous immunoglobulin
The subcutaneous immunoglobulin is infused in the subcutaneous tissue on the abdomen twice or thrice a week, with a maximal speed of 2 mL/h. Every time 20 mL is infused, the needle is removed to a new place.
Other Name: Subcuvia®
|
Detailed Description:
CIDP is an autoimmune disease of the peripheral nervous system, responding well to treatment with intravenous immunoglobulin (IVIg), steroids and plasmapheresis. IVIg is effective in treating patients with CIDP, but most of the patients need long time maintenance treatment, which is associated with decreased autonomy and regular hospital admissions. Furthermore many of the patients complain of infusion related side effects such as headache, chills and fatigue, and over time there is problems obtaining intravenous entry because of occlusion of the veins.
There is therefore a critical need for alternative methods to IVIg treatment. The aim of this study is to evaluate the efficacy, tolerability and safety of small doses of immunoglobulin administered subcutaneously (SCIg), compared with placebo. At the same time we compare the efficacy of SCIg with the regular IVIg treatment.
We therefore hypothesize, 1: SCIg is better than subcutaneous placebo infusions, and is as good as IVIg in maintaining muscle function in patients with CIDP. 2: SCIg home treatment is safe and tolerable. 3: SCIg home treatment is preferred to IVIg under hospital admission, by the patients.
Eligibility| Ages Eligible for Study: | 18 Years to 80 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- All patients with typical or pure motor CIDP, who meet the clinical or electrophysiological criteria of the EFNS/PNS for certain or probable CIDP and who are in regular treatment with IVIg on one of the neurological departments in Denmark, are eligible for the study
Exclusion Criteria:
- Pregnancy
- Known cancer disease
- Severe medical diseases
- Other immuno modulating treatment than low-dose steroid (prednisolone < 25 mg/day) within the last 6 weeks before inclusion
- Hepatitis B or C or HIV
- Breast-feeding
- Non-responding to treatment with intravenous immunoglobulin
- Known hypersensitivity to intravenous immunoglobulins or Kiovig
Adverse events:
- Previous moderate headache or minor rash for a few days during or after infusion is not an exclusion criteria
- In case of severe adverse effects to treatment patients are excluded. Moderate or mild side-effects can be treated with analgetics or steroids for 1-2 weeks during the initial study phase
Contacts and Locations| Denmark | |
| Aarhus University Hospital, Noerrebrogade, Department of Neurology | |
| Aarhus, Denmark, 8000 | |
| Principal Investigator: | Johannes Jakobsen, Dr., MD |
More Information
No publications provided
| Responsible Party: | University of Aarhus |
| ClinicalTrials.gov Identifier: | NCT01017159 History of Changes |
| Other Study ID Numbers: | EudraCT number: 2009-013930-25 |
| Study First Received: | November 6, 2009 |
| Last Updated: | November 9, 2011 |
| Health Authority: | Denmark: Danish Dataprotection Agency Denmark: Danish Medicines Agency |
Keywords provided by University of Aarhus:
|
Polyradiculoneuropathy, Chronic Inflammatory Demyelinating Subcutaneous immunoglobulin |
Additional relevant MeSH terms:
|
Polyradiculoneuropathy Polyradiculoneuropathy, Chronic Inflammatory Demyelinating Autoimmune Diseases of the Nervous System Nervous System Diseases Demyelinating Diseases Polyneuropathies Peripheral Nervous System Diseases Neuromuscular Diseases |
Autoimmune Diseases Immune System Diseases Immunoglobulins Antibodies Immunologic Factors Physiological Effects of Drugs Pharmacologic Actions |
ClinicalTrials.gov processed this record on May 22, 2013