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Trial record 1 of 2 for:    Neurological Consequences of Cytomegalovirus Infection
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Evaluation of the Safety and Efficacy of Standard Intravenous Immunoglobulins in Pregnant Women With Primary Cytomegalovirus Infection

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ClinicalTrials.gov Identifier: NCT01659684
Recruitment Status : Unknown
Verified August 2012 by Dr. Giustino Parruti, Azienda Sanitaria Locale di Pescara.
Recruitment status was:  Recruiting
First Posted : August 8, 2012
Last Update Posted : August 8, 2012
Sponsor:
Collaborators:
Regione Abruzzo, Italy
Azienda Sanitaria Locale di Pescara
Information provided by (Responsible Party):
Dr. Giustino Parruti, Azienda Sanitaria Locale di Pescara

Brief Summary:
Because the potential benefit of standard intravenous immunoglobulins (IVIG) - obtained from unselected donor pools including a varying proportion of donors previously exposed to CMV - has not yet been explored in pregnant women, the investigators performed a longitudinal prospective study on the possible efficacy of IVIG for prevention or therapy of fetal CMV infection.

Condition or disease Intervention/treatment Phase
Cytomegalovirus Congenital Infection Biological: standard intravenous immunoglobulin Not Applicable

Detailed Description:

Human IVIG are offered monthly to consecutive enrolled pregnant women with confirmed primary CMV infection at any stage, for the prevention and treatment of fetal CMV infection. Primary infection is defined by positive CMV IgM antibodies with absent or low titres of CMV IgG antibodies, and either low (<40%) CMV IgG avidity indexes with positive CMV IgM AND IgG antibodies. In addition women with indefinite avidity index and positive CMV DNA detection in urine and/or blood samples are also considered for treatment. Standard human intravenous immunoglobulins were chosen for their safety and efficacy, well documented in other settings. IVIGs were used to perform all of the infusions in the study, undiluted after reconstitution, in accordance with instructions of the manufacturer. We chose to perform IVIG infusions using 0.5 g/Kg of body weight, to make sure that a dose of specific CMV IgG at least comparable with that carried by HIG were infused at each time point. Infusions last 4 to 5 hours, using a double lumen line to infuse approximately 1500 mL of either 5% glucose or saline solution in parallel with the undiluted IVIG preparation, to reduce the risk of infusion reactions.

CMV IgG and IgM antibodies and IgG avidity indexes are assayed before and after each IVIG infusion, within 15 minutes. Quantitative CMV DNA is amplified from whole blood and urine samples from pregnant women and neonates, using the Real-Time PCR, and on samples of amniotic fluid from women who required amniocentesis. The newborns will be followed for five years after delivery.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 300 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Prevention
Official Title: Evaluation of the Safety and Efficacy of Standard Intravenous Immunoglobulins in Pregnant Women With Primary Cytomegalovirus Infection
Study Start Date : October 2010
Estimated Primary Completion Date : November 2014
Estimated Study Completion Date : November 2014


Arm Intervention/treatment
Experimental: standard intravenous immunoglobulin
Single arm evaluation of neurological consequences of congenital CMV infection in comparison with historical untreated controls.
Biological: standard intravenous immunoglobulin
Human standard intravenous immunoglobulin (IVIG), 0.5 g/Kg of body weight, monthly after confirmation of primary gestational CMV infection




Primary Outcome Measures :
  1. Prevention of neurological damage due to Cytomegalovirus congenital infection [ Time Frame: Neonates will be followed for 5 years, that is the estimated period of time over which late neurological manifestations may ensue ]
    Number of infected newborns with neurological deficits divided by the total number of infected newborns


Secondary Outcome Measures :
  1. Evaluate safety of aspecific immunoglobulins in pregnant women with primary CMV infection [ Time Frame: Participants are followed during the infusion period, an expected average of 5 hours; possible minor side-effects are searched for at each follow up visit ]
    Number of women with symptoms or adverse events during infusions divided by the total number of treated women



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Ages Eligible for Study:   Child, Adult, Older Adult
Sexes Eligible for Study:   Female
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Pregnant women with confirmed primary CMV infection at any stage of gestation.

Exclusion Criteria:

  • Pregnant women with falsely positive CMV IgM antibodies or high (>40%) CMV IgG avidity indexes

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01659684


Locations
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Italy
Infection Disease Unit, Pescara General Hospital, Pescara, Italy Recruiting
Pescara, Abruzzo, Italy, 65124
Contact: Francesca D'Arcangelo, MD       francescadarcangelo@yahoo.it   
Contact: Antonina Sciacca, Secretary       a.sciacca@virgilio.it   
Sponsors and Collaborators
Fondazione Onlus Camillo De Lellis
Regione Abruzzo, Italy
Azienda Sanitaria Locale di Pescara
Investigators
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Principal Investigator: Giustino Parruti, MD, PhD Azienda Sanitaria Locale di Pescara
Additional Information:
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Responsible Party: Dr. Giustino Parruti, MD, PhD, Azienda Sanitaria Locale di Pescara
ClinicalTrials.gov Identifier: NCT01659684    
Other Study ID Numbers: IVIG-001
First Posted: August 8, 2012    Key Record Dates
Last Update Posted: August 8, 2012
Last Verified: August 2012
Keywords provided by Dr. Giustino Parruti, Azienda Sanitaria Locale di Pescara:
congenital CMV infection
standard immunoglobulins
immunoglobulin therapy
IgG CMV avidity index
Cytomegalovirus
Additional relevant MeSH terms:
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Infections
Communicable Diseases
Cytomegalovirus Infections
Herpesviridae Infections
DNA Virus Infections
Disease Attributes
Pathologic Processes
Virus Diseases
Immunoglobulins
Immunoglobulins, Intravenous
Antibodies
gamma-Globulins
Rho(D) Immune Globulin
Immunologic Factors
Physiological Effects of Drugs