A Pilot Study of Mitoxantrone for the Treatment of Recurrent Neuromyelitis Optica (Devic’s Disease)
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Purpose
Neuromyelitis optica (NMO) is a severe demyelinating disease that selectively involves the optic nerves and the spinal cord but usually spares the brain. NMO is considered to have a B cell induced pathogenesis. Mitoxantrone (MITO, Novantrone®), a synthetic anthracenedione approved for worsening relapsing-remitting multiple sclerosis (MS) and secondary progressive MS, has been shown to primarily suppress the humoral response. We conducted a prospective 2-year study to evaluate the benefit of MITO in five relapsing NMO patients.
| Condition | Intervention | Phase |
|---|---|---|
|
Neuromyelitis Optica Myelitis, Transverse Demyelinating Autoimmune Diseases, CNS Autoimmune Diseases of the Nervous System |
Drug: Mitoxantrone |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | A Pilot Study of Mitoxantrone for the Treatment of Recurrent Neuromyelitis Optica (Devic’s Disease) |
- Relapse rate
- Safety
| Estimated Enrollment: | 5 |
| Study Start Date: | August 2001 |
| Estimated Study Completion Date: | May 2004 |
The treatment protocol consisted of monthly 12 mg/m2 MITO intravenous infusions for 6 months followed by 3 additional treatments every 3 months. Neurological assessment including the determination of the Expanded Disability Status Scale (EDSS) score was performed every 3 months and during relapses. Orbital, brain and spinal cord MRI was performed at baseline, 3, 6, 12, 18, and 24 months. Visual evoked potentials and ophthalmologic evaluations were performed at baseline and annually.
Eligibility| Ages Eligible for Study: | 18 Years to 55 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Recurrent longitudinal myelitis (>3 segments of spinal cord involvement by MRI) with or without recurrent ON (unilateral or bilateral) but with normal brain MRI.
- Patients with recurrent longitudinally extensive myelitis without optic neuritis have an underlying pathology and serology similar to NMO and it is appropriate to consider this a form of NMO10.
- Cerebrospinal fluid required no intrathecal IgG synthesis or oligoclonal bands.
- Age was required to be 18-55 years
- Extended Disability Status Score ≤ 7.
Exclusion Criteria:
- Cardiac risk factors (e.g history of congestive heart failure and left ventricular ejection fraction (LVEF) < 50%
- Systemic diseases such as lupus, Sjogren’s syndrome, anti-phospholipid antibody syndrome, sarcoidosis, rheumatoid arthritis, or vitamin B12 deficiency
- Previous treatment with mitoxantrone or anthracyclines
Contacts and Locations| United States, New York | |
| Baird Multiple Sclerosis Center | |
| Buffalo, New York, United States, 14203 | |
| Study Director: | Bianca Weinstock-Guttman, M.D. | Baird Multiple Sclerosis Center |
More Information
Publications:
| ClinicalTrials.gov Identifier: | NCT00304291 History of Changes |
| Other Study ID Numbers: | JNI-NMO-101 |
| Study First Received: | March 15, 2006 |
| Last Updated: | November 27, 2006 |
| Health Authority: | United States: Food and Drug Administration |
Keywords provided by State University of New York at Buffalo:
|
Novantrone |
Additional relevant MeSH terms:
|
Autoimmune Diseases Myelitis Myelitis, Transverse Nervous System Diseases Neuromyelitis Optica Autoimmune Diseases of the Nervous System Demyelinating Autoimmune Diseases, CNS Immune System Diseases Central Nervous System Viral Diseases Virus Diseases Central Nervous System Infections Central Nervous System Diseases Spinal Cord Diseases Paraneoplastic Syndromes, Nervous System Nervous System Neoplasms |
Neoplasms by Site Neoplasms Paraneoplastic Syndromes Demyelinating Diseases Neurodegenerative Diseases Multiple Sclerosis Optic Neuritis Optic Nerve Diseases Cranial Nerve Diseases Eye Diseases Leukoencephalopathies Brain Diseases Mitoxantrone Antineoplastic Agents Therapeutic Uses |
ClinicalTrials.gov processed this record on May 22, 2013